Now.

In other news, Kentucky's Medicaid budget has doubled over the last five years and is now more than $20 billion.

Conservative lawmakers say the cost is too high and that Kentuckians aren't getting any healthier.

In tonight's legislative update, our Emily Sisk explains what the Medicaid Oversight and Advisory Board wants to do about it.

The big, beautiful bill, which was signed into law by President Donald Trump last summer, made significant changes to Medicaid.

It will substantially cut spending by reducing an estimated $1 trillion over the next ten years.

Americans will see the first impacts of H.R.

one on Medicaid on January 1st, 2027, but the Kentucky General Assembly is preparing for those impacts now with the Kentucky Medicaid Oversight and Advisory Board.

Today, the board finalized nearly a dozen findings related to Medicaid spending and how to move forward.

One of those findings says the current Medicaid delivery model, which has been in place since 2011, has not significantly improved health outcomes.

While the budget has grown unsustainably, the state's Medicaid budget has more than doubled over the past five years and is now more than $20 billion.

But one Democratic lawmaker argued that Kentucky's health outcomes are not as bad as the board was painting them out to be.

What data are we relying on to establish this criteria as a state, and what data do we want to rely on moving forward?

I mean, just to say that we're not improving health outcomes.

I mean, a quick review of data in the last 15 years or 16 years show that we have significantly improved our screening rates as a state significantly.

A lot of our health data has actually improved tremendously over the last 15 years.

Nothing else.

I mean, just look, over the last three years, our opioid deaths are down year after year after year.

What we're talking about outcomes.

We're talking about.

You're talking about data, a particular point of where a particular, issue is on health.

We're talking about trends.

We're talking about outcomes where what's the underlying issue in order to move that needle into a and to get a better rankings.

That's what we're talking about.

Our screening rates in this state have significantly improved.

Senator Byrd, you're talking about one particular I'm talking about broad spectrum.

And yes, I agree, there are some things that done quite well.

And we should be proud of those items and those and those movements and the and the health outcomes.

But when you look at things in total, in general, we need to look at things in totality in order to try to move, us up.

We're still in the bottom quartile in a lot of these health rankings, even though we moved some into a higher ranking.

Republican Senator Stephen Meredith doubled down on the idea that health outcomes have not improved, especially in rural parts of the state.

And has not improved in rural Kentucky, has in some areas.

But and we have not there has been some increases in some areas, but not related to the amount of expenditure that we're making for the program.

I mean, it honestly partially offends me as a health care provider because I think the health care providers in this state are doing an amazing job trying to keep people in this state healthy and have been happy.

In the rest of the board's findings, they recommended the state auditor conduct a comprehensive audit of the Medicaid program every five years to look for potential ways to cut down costs.

The board also recommended the establishment of work and community engagement standards for Medicaid recipients that would begin on January 1st, 2027.

For Kentucky Edition, I'm Emily Sisk.

Thank you Emily.

The Medicaid Oversight and Advisory Board will continue meeting monthly throughout the legislative session.