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Contact Information: AJ Jones aj.jones@kyvoicesforhealth.

org

FOR IMMEDIATE RELEASE Wednesday, April 6, 2016

Statement from Keep Kentucky Covered re: Kynect and Benefind


As consumer advocates working to ensure the health and well-being of all Kentuckians, we are
responding to Governor Bevins offer to listen to those who actually have hands-on knowledge
concerning the recent roll-out of benefind and the challenges it has produced. As part of our campaign
to Keep Kentucky Covered, Kentucky Voices for Health has established an Enrollment Transition
Workgroup to ensure a seamless transition as kynect is being dismantled. It is our position that any
enrollment system that replaces kynect must work just as well or better to ensure that all Kentuckians
have coverage and access to care without interruption or barriers.
We represent stakeholders from across the Commonwealth who have been involved in outreach,
education and enrollment efforts since 2013. These stakeholders work diligently every day to provide
access to and support for Kentuckians who are enrolling in or maintaining health insurance through our
marketplace.
While we are relieved that Governor Bevin and Cabinet leaders are taking steps to make sure
Kentuckians continue to receive their benefits in April, those steps do not result in a long-term solution
to the problem. Much more needs to be done to address this crisis and the harm that it has caused.
Kentucky consumer advocates have made several attempts to reach out to Cabinet officials before and
after the benefind roll-out with no success. Therefore, we are sharing our concerns, questions and
recommendations publicly, with the hope that this will result in the opportunity to work directly with
the Cabinet in the coming months to ensure that all Kentuckians return to full access to coverage
without barriers.

Reduced Access
At Governor Bevins press conference last Thursday, a comment was made that, benefind is kynect and
kynect is benefind, asserting that these are actually one system with no wrong door. But for people
needing Medicaid coverage and other social benefits right now, there is no right door for access, let
alone one door.
Tens of thousands of Kentuckians have already lost the benefits they rely on because benefind is not
working. This is more than a system glitch that is sending out thousands of erroneous letters. Our fellow
Kentuckians now find themselves in desperate, life-altering situations. Weve heard from Kentuckians
who cannot get medicine for their kids, cannot get their lab tests run, and are sharing insulin with family
members. Even more alarming, we are now aware that some Kentuckians are losing their health
coverage in addition to other benefits like SNAP, KTAP, and waivers. These are services that we know
are vital to the health and well-being of our most vulnerable citizens.
To date, more than 51,000 cases have been identified, according to Administration officials, and many
are still without benefits, despite the commitment to keep Kentuckians covered in April.
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System Issues Affecting Enrollment


The bottom line is that benefind was never built to replace kynect. benefind was designed to be a
complementary system to be integrated with kynect to create a one-stop-shop for all benefits. kynect
was built to provide access to health insurance and Medicaid enrollment; and benefind was built to
enhance kynect with additional social services benefits. While theyre part of the same system, they
provide different essential functions.
There are two serious problems with using benefind for Medicaid enrollment.
The first is that benefind lacks important service portal functions vital to kynectors. In addition to new
access barriers, the following system issues have been and continue to be reported:
Applications of individuals and families who have long been assigned to kynectors are
disappearing from their accounts and then cannot be retrieved-- with no explanation.
Application errors are affecting Medicaid and Qualified Health Plan (QHP) enrollees alike.
The necessary feature to report a change in circumstance has been missing from kynect and
benefind, meaning that an individual or family is unable to report a change in income, family
size, or other factors that affect their eligibility for Medicaid or QHP subsidies.
The second serious problem is that the Department for Community Based Services (DCBS), the agency
responsible for benefind, is woefully understaffed and unable to take on such a high volume of
enrollment and benefits maintenance work.
Call center hours were recently cut back, leaving a window from 8am-3pm in which to get
application assistance.
Calls are not transferred from the kynect call center to DCBS after 2pm.
Call center wait times exceed 2 hours and thousands of calls go unanswered every day.
There are still four counties with no in-person assistance for consumers. At least eight counties
across the state have had no DCBS office hours in the last month. This is a significant decrease in
access to help for Kentuckians in those counties especially since this information is subject to
change.
Mandatory overtime has been revoked and staff shortages are being used to balance the
budget, with more cuts ahead.
kynectors may still be on contract but, without access to those necessary functions, they cannot do their
jobs. Furthermore, there was no official communication with kynectors about system changes until April
1st, more than a month after the first problems started to be reported. As a result, the capacity of nearly
500 kynectors has been lost and consumers are left to fend for themselves to ensure that their
application gets completed and processed successfully.

Many Challenges and Questions Remain


As DCBS and Deloitte work to improve benefind, there are many questions that remain unanswered
regarding the scope of this crisis and how the Cabinet will be able to ensure that no one loses coverage
from here on out:
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1) How many people, if any, lost benefits without cause from February 29 to today (including but
not limited to: all waivers, MAGI and traditional Medicaid, Medicare savings programs, SNAP,
KTAP, and childcare assistance)? Were there beneficiaries of any other benefit programs that
were affected?
2) How many letters were sent to individuals and families erroneously stating that they were not
eligible for one or more of their current benefits?
3) Why were benefits revoked immediately, with no warning period or opportunity for appeal?
4) How many individuals have contacted the Ombudsmans office and how are they being
addressed?
5) How will the Cabinet ensure that all of the individuals and families who were wrongfully disenrolled are aware of their rights and get their benefits reinstated as soon as possible? What
type of communication has been provided directly to consumers or to providers to explain that
they still have coverage for April if they had coverage in March?
6) How will the MCOs and providers be able to serve those who were wrongfully dis-enrolled since
February 29th who havent been able to get re-enrolled due to system errors and the inability to
get assistance from DCBS? Are the MCOs and providers expected to provide services without
payment?
7) How quickly can DCBS and Deloitte onboard and train additional personnel in order to address
the system errors and backlog of cases? And how much will this cost? Will this cost be reported
as a Medicaid expense? What portion, if any, is Deloitte absorbing?
8) When can we expect the full spectrum of enrollment activities to be restored to normal?
9) Will kynectors be given access to a service portal dashboard in benefind so they can continue to
do their jobs and share the workload with DCBS and Deloitte?
10) How much will it cost the state to deal with these problems?
11) Where are the funds in the budget to repair the errors, backlog, hearings, etcetera, due to
benefinds premature rollout?
12) What will be the effect of the additional costs to repair the damage if the state does not have a
budget?
13) Realistically, how does the Cabinet plan to meet the CMS deadline of June 1st to demonstrate
that they can successfully take on an equally complex tech challenge in building the account
transfer and minimum essential coverage checks between benefind and healthcare.gov? Not
only does that daunting task need to be accomplished over the next seven weeks, but at the
same time, the current crisis and tech functional failures need to be fully resolved, tested and
fully operational.
14) Most importantly, what is this costing the low-income families and vulnerable Kentuckians who
have lost coverage and dont have their basic needs met? How will the state make those
Kentuckians whole? How will the state compensate those Kentuckians who have been told they
wouldnt have food to eat starting in a week or that they didnt have any way to pay for their
blood pressure medicine or oxygen? What is in place to monitor and measure these ongoing
harms until benefind and kynect are fully functional?
Kentuckians deserve answers to these questions.
(continued next page.)
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Dismantling kynect Means Fewer Kentuckians Stay Covered


As the Administration continues their efforts to dismantle kynect, the coverage of more than 1.4 million
Kentuckians hangs in the balance. With the current state of benefind and a greatly under-staffed DCBS,
it is now clear that we are not simply creating an alternative system for enrollment, but an inferior one.
Using benefind as the primary system for Medicaid enrollment was premature and untested, even
while benefinds other functions were reportedly tested to some degree. This provides a clear window
to the transition challenges that lie ahead.
With more than two years of experience in using both the state-based and federal marketplaces, there
is now unequivocal evidence that kynect is the gold standard. According to a recent study published by
the Commonwealth Institute, we now know that the coverage gains made by the highest performing
state using the federal marketplace are still, nearly 40 percentage points lower than that achieved in
Kentucky. The researchers go on to conclude that, Should HHS let the state abandon kynect and adopt
an assessment and referral approach for Medicaid eligibility in its relationship with HealthCare.gov,
hundreds of thousands of residents could be affected and, At the very minimum, ending kynect must
be understood as a major challenge to Medicaids ability to function as effectively for Kentuckys
poorest residents. This is, undeniably, a bad outcome for Kentucky.
Furthermore, nation-wide studies have revealed that halffully fifty percent-- of individuals and
families at or below 200% of the federal poverty level (about $24,000 for an individual and $49,000 for a
family of four) will move back and forth between Medicaid and healthcare.gov each year. Dismantling
kynect will mean extra steps and more delays for our hardest working Kentuckians who will have to start
navigating two systems with less assistance available to them.

Transition Challenges
From our viewpoint, it appears that Kentucky will not be ready for a seamless transition to
healthcare.gov for the 2016 open enrollment period. Before going any further with this transition, its
critical that we know the following at a minimum:
1) When will the required transition plan be available for consumer input and public comment?
2) Who is the appropriate contact person for consumers with concerns about a possible transition?
Who is leading the transition?
3) What is the status of the required transition plan that must be approved by CMS before starting
to dismantle kynect? Is it on track to be approved by June 1st?
4) Was the Medicaid Advanced Planning Document submitted by April 1st as required by CMS?
When will this document be made available to the public?
5) How will Kentuckians be notified of the transition and where they can go for information, to
enroll in coverage or to get personal assistance?
6) How much outreach, and how many dedicated outreach and enrollment workers will be
maintained by the State to provide boot-on-the-ground assistance?
7) If kynect/KOHBIE no longer exists, which agency will coordinate and fund outreach and
enrollment workers?

We Can Do Better by Improving benefind and Keeping kynect


By creating a system in which fewer Kentuckians are able to keep their coverage, we stand to lose much
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more than affordable access to care. We stand to lose the critical gains weve made in prevention, the
more than 10,500 jobs that have been created, and over $3 billion in additional revenue flowing to
providers in every county across the Commonwealth and being re-invested in their communities.
Dismantling kynect and using benefind for Medicaid enrollment is a choice. We can make a better one.

We recommend the following actions be taken as soon as possible in order to ensure that all
Kentuckians have access to the benefits they are eligible for:
1) Keep using kynect for Medicaid and QHP enrollment. The best and most immediate solution is
to use benefind as it was originally designed as an enhancement to kynect for additional DCBS
benefits.
2) If a transition plan is approved by CMS to dismantle kynect and build a Federally-supported
State-based Marketplace (FSSBM), benefind must be re-designed to function seamlessly as part
of the FSSBM. To accomplish this, benefind must have the same functionality for Medicaid
enrollment as kynect, including a service portal dashboard for all enrollment workers.
3) Continue using the kynect Advisory Board and Committees to work collaboratively with
stakeholders. kynects Advisory Board and Sub-committees have been extraordinarily effective
at bringing stakeholders to the table to work together with Cabinet officials to find solutions. If,
as planned, kynect is in fact dismantled, we believe that this committee structure must be
maintained and used for benefind and the FSSBM moving forward. Maintaining the current
advisory structure provides transparency, gives opportunities for important feedback and
recommendations, encourages collaboration, and will be our best opportunity to ensure a
seamless transition in which no Kentuckian loses their coverage.
We hope that these concerns, questions and recommendations are received in the spirit that they were
requested-- as valuable input from those with knowledge accumulated over time and through direct
experience with these systems and the Kentuckians they affect. As Kentuckys consumer advocates, we
stand ready and willing to work with the Administration and the Cabinet to find the best solutions to
keep Kentucky covered.

Kentucky Voices for Health is a 501(c)3 organization www.kentuckyvoicesforhealth.org


Kentucky Equal Justice Center is a 501(c)3 organization www.kyequaljustice.org
Kentucky Center for Ecnomic Policy is a 501(c)3 organization www.kypolicy.org

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