FRANKFORT, Ky. – Kentucky is shifting forward to revamp the state’s Medicaid program, including work necessities and other modifications sought by Gov. Matt Bevin, the state’s prime human providers official advised lawmakers Tuesday.

Adam Meier, secretary of the Cupboard for Health and Family Providers, advised the joint  House Senate Well being and Welfare and Household Providers Committee the state expects to start introducing modifications April 1, following the approval last week of Kentucky’s plan by the Trump administration.

He said he hopes to avoid some of the turmoil of the last attempt to introduce the changes when a federal judge in Washington struck down the state’s initial plan on June 29 and sent it back to the federal Centers for Medicare and Medicaid Services for further review.

Reversing changes already in place for the state’s complex Medicaid system “had to be done at the last minute,” he said to the lawmakers.

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This time, Meier said the state will have more time to plan for launching the system that will affect largely “able-bodied adults” among the 500,000 people added to Medicaid under a 2014 expansion allowed by the Affordable Care Act.

Kentucky’s $11 billion-a-year Medicaid program provided health coverage for about 1.3 million people.

In addition to the requirement that they work or volunteer 20 hours a week to keep health benefits through Medicaid, those affected by Bevin’s changes will lose basic dental and vision coverage. To purchase such care, they will be required to earn points through a “My Rewards program” by activities such as volunteering or taking online classes.

The state’s dentists and eye doctors have strongly objected to that change, saying such care is essential in a poor state with significant oral health and eye care needs.

Meier said the overall goal of the changes is to help people “graduate” from Medicaid, a federal-state health plan, to commercial or employer insurance.

“It’s not about losing coverage, it’s about having fewer people in Medicaid,” he said.

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Critics have said most people added through the Medicaid expansion already work low-wage or part-time jobs that don’t include health insurance.

Rep. Joni Jenkins, a Louisville Democrat, asked Meier whether Kentucky’s experience might be similar to Arkansas, the first state to introduce work requirements, which lost 12,000 people from Medicaid in the first three months.

Meier said that it’s not clear yet what caused people to leave Medicaid in Arkansas, and that Kentucky will provide a “very robust evaluation and monitoring plan” to follow people and determine whether they move to private insurance or choose not to meet the new requirements.

Lawmakers also…