By Louisville Courier-Journal
The stubborn refusal of the Cabinet for Health and Family Services to help more than 8,000 poor, Eastern Kentucky residents get acceptable health care through the state’s problem-ridden Medicaid, managed-care system has landed the cabinet where it should be: in contempt of court.
An exasperated U.S. District Judge Karl Forester this week found the cabinet in contempt for refusing to follow his order to help Medicaid members switch to a managed-care company that ensures they can get care through the region’s major health provider, Appalachian Regional Healthcare. The underlying legal dispute between Coventry Cares, a for-profit company that currently serves the affected Medicaid members and Appalachian Regional, a non-profit system of hospitals and health services, is mind-blowingly complex. The cabinet’s actions are not. Cabinet officials and lawyers led by general counsel Christina Heavrin told Judge Forester and Appalachian Regional the cabinet was prepared to move Medicaid members to a different managed care company to ensure ongoing health care while Coventry and Appalachian Regional fight out a contract dispute in court. The judge signed an order to that effect.
Then the cabinet did almost nothing, leaving more than 8,000 Medicaid members who requested the move in limbo. The cabinet’s excuse? It merely said it could help the members make the switch. It never promised it would.
Such legal hair-splitting, which has come to represent the cabinet’s courtroom tactics, not only shows contempt for the court. It shows contempt for the more than 500,000 people statewide served through the eight-month-old, Medicaid managed-care experiment who struggle daily with colossal delays and denials of care.
Judge Forester has not yet issued sanctions for the cabinet’s bad behavior. We hope sanctions are significant enough to get the attention of top officials in the administration of Gov. Steve Beshear. Perhaps certain officials should start packing a toothbrush. Or their checkbooks.
Meanwhile, the cabinet should be mindful of the words of Judge Forester, who has spent his career as a lawyer and judge in the Eastern Kentucky region and knows whereof he speaks. Southeastern Kentucky’s Medicaid population includes the “poorest of the poor, the neediest of the needy and the least educated,“ he wrote. “The health and well-being of thousands of these patients hang in the balance.”