It’s the 10-day veto period for the Kentucky General Assembly, that time of quiet when lawmakers rest-up before the hectic final two days of the session and await news from Gov. Andy Beshear on what bills he has signed, vetoed, or will allow to become law without his signature. During their break, Kentucky Tonight spoke with four legislators about their work so far this year.
The flurry of last-minute bills Republican leaders sought to protect from a gubernatorial veto included significant changes to the state’s Medicaid program. A Senate committee substitute to House Bill 695, added just hours before the midnight deadline, mandates a work requirement to for able-bodied Medicaid enrollees.
About 1.4 million Kentuckians are on Medicaid, which costs the state about $16 billion a year, according to state Sen. Phillip Wheeler (R-Pikeville). With those costs expected go even higher, Wheeler says lawmakers had to act, especially given the possibility of funding cuts that could come at the federal level.
“I want to make sure that the fiscal stability of Medicaid continues so that that program will remain available for those that need it, particularly the disabled, the working poor, children, pregnant mothers, those type of folks,” says Wheeler.
Under the change, adult beneficiaries without children or a disability would be required to work 20 hours a week or participate in a state job placement program to maintain their coverage. Wheeler says that’s not too much to ask in return for government-funded health care coverage. Democrats decried the change and the late-night rush to pass it.
“We barely got to read the bill before we had to vote on it,” says Sen. Robin Webb (D-Grayson). “I think we might’ve moved too quickly on this with something that we should’ve talked about more in the interim and come up with a more workable solution in the next session.”
Webb says she’s worried about the administrative costs to track the work mandate. She also wonders why Republicans made no provisions for people living in areas with limited job opportunities, and how financially struggling rural hospitals might be impacted. Rep. Lindsey Burke (D-Lexington) says she’s uncertain whether the mandate will withstand legal challenges that overturned a similar requirement pushed by former Gov. Matt Bevin in 2018.
“It was disappointing that we didn’t have time to continue that debate and discussion on behalf of all the people who will be affected,” says Burke, who is the House Minority Whip.
Another provision of HB 695 creates a Medicaid Oversight and Advisory Board. Legislative leadership will appoint members to that group, which is tasked with reviewing the efficiency and effectiveness of Medicaid services. Rep. Kimberly Poore Moser (R-Taylor Mill), chair of the House Health Services Committee, has been working on the idea for such a board since last year. She says Kentuckians need the safety net that Medicaid provides, but she adds that lawmakers need a way to audit the ever-increasing costs of the program.
“I would never advocate that we do away with... Medicaid, that’s not what I’m saying at all,” says Moser. “It’s just making sure that what we’re paying for is actually making a difference in the lives of the people we serve.”
Debate over Gender-Affirming Health Care
House Bill 495, which reverses Gov Andy Beshear’s executive order to ban conversion therapy, also got a late committee substitute that prohibits Medicaid funds from being spent on gender-affirming care.
Moser says she was surprised by that addition, especially since Medicaid doesn’t cover elective procedures, which is what she considers gender-reassignment surgeries to be in many cases.
Meanwhile, Senate Bill 2 prohibits public dollars from paying for gender-affirming care for jail or prison inmates, even if the person was already receiving those treatments at the time of their incarceration. Wheeler says that the provision seeks to reverse an administrative regulation the Beshear administration pushed through instead of bringing it to the General Assembly for debate.
“If it was a discussion that he wanted to have,” Wheeler says, “why not come to the legislature and argue the merits of this policy?”
But Burke and Moser say there can be medical complications to suddenly ending treatment for someone already on hormone therapy. Moser originally proposed language that said the treatments could not be stopped if a health care professional deemed the action to be medically harmful to the inmate. Burke says it may cost taxpayers more to pay the bills for an inmate harmed by ending treatment than to pay for the hormone therapy itself. She contends lawmakers could have found a more compassionate and fiscally responsible way to address the issue.
“I understand that people across Kentucky may not know anyone who’s transgender, they may find it objectionable morally or ethically, but it is a well-established medical diagnosis,” says Burke. “So for us to say that they must immediately cease those treatments, which is hazardous, is really problematic to me.”
Webb says the debate over SB 2 also failed to address how local jails and state prisons treat transgender inmates in general.
“I’d just like to see a rational conversation on how corrections can deal with these populations as far as segregation or classification... to keep us out of court and to provide a humanitarian solution,” says Webb. “Whether you like it or not, we are the custodians of these individuals.”
As for overturning the ban on conversion therapy in HB 495, Wheeler says that’s another matter that should’ve been decided by the legislature, not by a governor’s executive order. Conversion therapies seek to reverse the sexual preferences of LGBTQ youth. Opponents and groups like the American Psychological Association contend the therapies are controversial, medically unproven, and endanger a patient’s mental health. Moser says she doesn’t want anyone to be hurt by conversion therapy practices, but she says harm should be determined by professional groups that license therapists.
“It returns the counseling issue back to the licensure boards, who really should be dictating all of this,” says Moser. “They should be deciding whether or not there is some sort of malpractice and penalizing their practitioners if there is malpractice.”
Other Legislative Actions and Inactions
Controversy also surrounds Senate Bill 89, which redefines Kentucky’s navigable waterways and aligns state water quality regulations with federal mandates. Burke contends the measure goes too far in deregulating water resources in the commonwealth, especially, she says, when the Trump administration is slashing federal environmental protections.
“I got five times more emails about Senate Bill 89 than any other topic,” says Burke. “The people of Kentucky are deeply concerned that we are going to lose the ability to enjoy and benefit from our natural beauty including our water sources.”
Wheeler says SB 89 is meant to address concerns that state environmental officials were unfairly delaying or denying construction, mining, and farming activities over what constitutes a navigable waterway.
“We had some problems with the (Kentucky Energy and Environment) Cabinet issuing the appropriate permits and essentially trying to act like California rather than Kentucky,” says Wheeler. “I’m not saying it’s a perfect bill by any means, but I think it did strike the right balance for economic development and protection of resources that we all love and enjoy.”
Lawmakers also approved a measure to create a Kentucky Film Office to better promote television and movie production within the commonwealth. Wheeler says the office can help market the state, and Moser says it will generate new jobs and millions in tax revenues.
Republicans also pushed through changes to how the state implements future income tax reductions. Currently lawmakers can drop the income tax rate by 0.5 percent when certain budget metrics are met. Under House Bill 775, the General Assembly could cut the tax rate by smaller increments, from 0.1 percent to 0.4 percent, even if the state fails to meet existing budgetary triggers.
Burke says she respects the disciplined approach to cutting taxes Republican leaders instituted in 2022, but she says HB 775 moves the goalposts at a time of great economic uncertainty at the federal level. Moser says the change is part of a continuing process to review how the state collects and spends money.
“I want to be cautious and I want to be careful as we move forward, but I would like to get our taxes down for our people,” says Moser. “I think it really will force us to find a balancing act between how much we tax our citizens and those services that we do need to provide.”
Lawmakers have taken no action to give state government retirees a cost-of-living adjustment. Wheeler says he sympathizes with retirees who haven’t received a COLA in a decade, but he says lawmakers must maintain a balanced budget. The legislature has also yet to address salary compression among state government employees, which can result in new hires earning more than veteran workers.
Wheeler acknowledges that it is an unfair situation, but he adds that long-time employees will receive better pension benefits than recently hired workers. Webb says the issue is a topic of ongoing discussions among lawmakers.
“It’s just not equitable for our long-time state employees,” says Webb. “We’ve got to have those entry salaries to attract and compete with private industry... but certainly it is not fair to the long-time state employee to have such a disparity of salary.”
