FRANKFORT — The Kentucky Senate has lowered the copays Medicaid patients would have to pay under a bill that proposes a work requirement and other sweeping changes to the federal-state program.  House Bill 2 proposed adding copays of $35 for inpatient hospital services and $8 copays for prescrip tion glasses and contacts.  In the Senate version, which passed the Senate health services committee unanimously Tuesday, copays are still included, but they’ve been slashed. Under the current version, health care services would carry a $5 copay and prescription drugs would have $1 copays.  Senators “felt like we had to put some sort of benchmark in there to kind of go with ownership of your health care,” Sen. Julie Raque Adams, R-Louisville, said in committee.  The Senate is on the same page as the House in “trying to change behavior” by imposing copays, Raque Adams said.  “Rather than go into the emergency room for your primary care, we want to try to have you find your primary care home outside of the emergency room,” she said. “What we felt was more appropriate is to have all of those behavioral changes happen, but with a lower fee, because what will end up happening is that they won’t be able to collect that fee, and that will come out of the providers’ reimbursement rates. So it would be a hit to the provider on the outset.”  Medicaid is the federal-state program that pays for almost 1 in 3 Kentuckians’ health care. In 2025, Congress cut Medicaid spending over 10 years by $880 billion as part of the sweeping One Big Beautiful Bill Act.  The Senate’s version still requires people who have Medicaid to demonstrate “community engagement,” which is work or volunteering.  Jason Dunn, former director of the Division of Family Support within the Department for Community Based Services in Kentucky’s Cabinet for Health and Family Services, said the Senate made “some very good, positive changes” to the bill.  “There’s still some concerns that I have, though,” he said. “I’ve seen firsthand the impact of rules that create barriers for otherwise eligible people. They lead to unnecessary denials, delayed access and contribute to application churn, and this adds new burdens and uncertainty for recipients and higher costs.”   Dunn said “there’s always a balance to strike between access and over-verification” but parts of HB2 “continue to miss this balance, valuing program integrity at the expense of access” despite Senate changes   This will happen, Dunn said, “at the expense of access to otherwise eligible Kentuckians trying to navigate through the red tape” all while “the agency is ultimately going to spend more to serve fewer low income Kentuckians” which he said “doesn’t make us healthier, (and) ultimately, may not save us any money.”  Senate edits: ‘A work in progress’   Other features of the Senate’s version include:  The House version blocked Kentucky Medicaid from providing “coverage for prescription drugs when prescribed primarily for weight loss or weight management purposes.” The Senate changed that portion of the bill to block only coverage of “prescription drugs when prescribed primarily for weight loss.” Sen. Craig Richardson, R-Hopkinsville, said this change “is to capture and not penalize or have any unintended consequences of those individuals that may be seeking drug coverage for things with eating disorders or weight management in general.”  In the House version, new Medicaid members would have been required to prove “community engagement” for the month prior to application. Existing members seeking redetermination (renewal) need to show this for three consecutive of the six previous months. The Senate removed the word “consecutive” to just allow for three months prior.  Under the House version of HB2, the Kentucky auditor would have had to conduct “a full and comprehensive examination” of Kentucky’s Medicaid program beginning July 1 and at least once every five years, examining the program’s finances and compliance with federal law. The Senate deleted this requirement. The senate version still requires regular audits but gives authority to the Legislative Research Commission to direct them.  The Senate allows Medicaid-covered Kentuckians to “self attest” certain eligibility points including income, residency, age, household composition and caretaker or relative status, undoing the House’s block on self attestation. This change, which is labeled in the bill as a “last resort” is meant to “allow more flexibility and to hopefully eliminate any due process concerns that may arise with that,” Richardson said.  Emily Beauregard, the executive director of Kentucky Voices for Health, thanked the Senate for the changes to the bill and asked for continued work on it.  Emily Beauregard, the Executive Director for Kentucky Voices for Health, speaking to the Medicaid Oversight and Advisory Board on Feb. 23, 2026. (Kentucky Lantern photo by Sarah Ladd) “Eligibility verification is a critical balance to get right,” she said. “Any data that can be verified without asking a household to do more paperwork is always the right approach, but the balance to that approach is to make sure that we’re not letting one conflicting data source determine a person to be ineligible for Medicaid. This is a due process issue.”  Even with the changes, she said, “any beneficiary, including pregnant women, people with disabilities and seniors, could lose their Medicaid coverage before they’re even aware of the problem or given the chance to submit additional documentation to resolve the conflict.”  Sen. Stephen Meredith, R-Leitchfield, the committee chair, said lawmakers were already looking at and considering some of the issues brought up by those who testified Tuesday.  “We won’t get it perfect this time, but we will be back in about nine months, and we’ll continue to work on this,” he said. “This is a work in progress.”   Read the Senate version 26 RS HB 2 PSS 2 SENATE MEDICAID SUB GET THE MORNING HEADLINES. SUBSCRIBE The post KY bill making sweeping changes to Medicaid adds copays (but they’re lower now) appeared first on The Lexington Times. ...read more read less