House passes Medicaid reform bill February 27, 2026 Rep. Ken Fleming, R-Louisville, speaks on the Kentucky Medicaid Reform Act found in House Bill 2 on the House floor on Friday. A high-res version is available here. FRANKFORT — A major overhaul to Kentucky’s Medicaid program is on the m ove in the Kentucky General Assembly. The Kentucky House of Representatives passed House Bill 2 on Friday after nearly two hours of debate. Rep. Ken Fleming, R-Louisville, is the primary sponsor of the legislation. He said the first nine sections of HB 2 would bring state Medicaid law in line with the House Resolution 1, or the One Big Beautiful Bill Act, that U.S. Congress passed last year. “The federal government has shifted the financial burden of Medicaid to Kentucky,” he said, adding that Medicaid coverage for a third of Kentuckians is the second largest state expense. In addition to implementing new federal law, the Kentucky Medicaid Reform Act also aims to implement recommendations from the state Medicaid Oversight and Advisory Board. This includes enhancing transparency, bettering health outcomes, streamlining program operations and delivery, strengthening program oversight and accountability, and reducing fraud, Fleming said. The HR 1 provisions of the bill would address new federal community engagement, cost sharing and eligibility requirements. Fleming said the general assembly’s response to HR 1 would focus on the Medicaid expansion population and not the traditional recipients. There are also specific carve outs to exempt certain members of the Medicaid population. “These populations include pregnant women, caregivers for a dependent child under 13, and individuals with serious and chronic health conditions,” Fleming said. Children and individuals on community-based waivers would also be exempt. Fleming said HB 2 promotes personal responsibility without limiting access to essential care. “It increases eligibility integrity by implementing safeguards to ensure only eligible Kentuckians are enrolled in our Medicaid program,” Fleming said. Other provisions of HB 2 include reforming the appeals and auditing process, limiting coverage for glp-1 weight loss medication to medical-necessity only, and requiring the state auditor to conduct an audit of the program at least once every five years, Fleming said. Critical debate of HB 2 included concerns the bill will result in less Kentuckians in need receiving care and put an undue burden on those subjected to the cost sharing and community engagement requirements. Rep. Adam Moore, D-Lexington, said he is in support of the bill’s goal to reduce fraud and ensure recipients are seeing their primary care physicians more and going to the emergency department less. He said he does, however, still have concerns about the cost sharing requirements of the legislation going beyond the federal requirements. “We all share a goal of ensuring that the long-term sustainability of our Medicaid program, but we need to be careful that in our pursuit of oversight that we don’t actually build a pay-to-play health care system that punishes or leaves out Kentuckians that this program was designed to protect,” Moore said. Fleming said the $20 copay provision of HB 2 would not go into effect until Oct. 1, 2028. If HB 2 becomes law, the Medicaid Oversight and Advisory Board would do a study. “If we find through that data, through surveys, through whatever information we get that it’s not prudent to do this, we have two sessions before this takes effect to react to that,” Fleming said. HB 2 now heads to the Senate after a 77-21 House vote. The post House passes Medicaid reform bill appeared first on The Lexington Times. ...read more read less