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Will Kentucky have Medicaid work requirements? What the state is planning under new law

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Will Kentucky have Medicaid work requirements? What the state is planning under new law


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  • Kentucky plans to implement new Medicaid work requirements for certain “able-bodied” adults.
  • The program aims to connect recipients with job placement assistance, education, and training.
  • Approximately 75,000 Medicaid expansion recipients are estimated to be affected.
  • The state anticipates $184 million in Medicaid savings over five years.

Kentucky officials laid out how they plan to enact new Medicaid requirements in a public notice published May 13.

According to the notice, the state’s Department for Medicaid Services is seeking federal approval to implement a community engagement waiver program, with the goal of supporting “individuals in gaining economic stability” by connecting them to educational and job assistance programs.

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The request comes after the Kentucky General Assembly passed a bill during the 2025 legislative session that requires some “able-bodied adults” to participate in such a program, after being approved and established by the Cabinet for Health and Family Services.

It also comes amid discussion of work requirements for Medicaid recipients nationally, with House Republicans proposing changes to the program as they attempt to reduce billions in spending.

Here’s what to know about the state’s proposal.

Who would be required to participate in Kentucky’s community engagement waiver program?

According to the public notice, the program would apply to adults in the state’s Medicaid expansion, who have been enrolled for more than 12 months and:

  • Are between 19 and 60 years old;
  • Are physically and mentally able to work, as defined by the Cabinet for Health and Family Services;
  • Are not primarily responsible for the care of a dependent child or disabled adult relative.

Who could be exempt from Kentucky’s program?

The notice states the Department for Medicaid Services will review members for possible exemptions and will not require participation for those who meet one or more criteria, including:

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  • People with diagnosed substance use disorder or serious mental illness;
  • People with a chronic disease or acute medical condition that prevents them from complying with requirements;
  • People who have been deemed disabled;
  • People with verified earned income or who receive unemployment insurance;
  • Pregnant women;
  • People who are victims of domestic violence;
  • People who are homeless or were recently homeless;
  • People who have recently been impacted by a catastrophic event, such as a natural disaster or death of a family member in their household;
  • Former foster youth up to age 26.

How will Kentucky’s community engagement waiver program work?

Under the proposal, the Department for Medicaid Services will refer eligible adults to the Kentucky Education and Labor Cabinet’s Department of Workforce Development.

That department will then reach out to members with available job placement assistance programs.

“For individuals who agree to receive support, DWD will connect them with supports such as apprenticeships, career development, education, employment and training, and will provide support in preparing them to enter the workforce, advance their careers, improve job performance, and fill skills gaps,” the notice states.

How many people are expected to be eligible for the program?

The public notice estimates around 75,000 people will be “subject to the requirements of this waiver.”

About 488,000 people were covered by Kentucky’s Medicaid expansion as of 2024, according to federal data.

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Officials expect “a minimal impact to enrollment” as recipients “are able to identify gainful employment through the community engagement process and therefore are no longer eligible for Medicaid,” the notice states.

How could the program effect spending on Medicaid?

Kentucky officials expect to spend less on Medicaid as expansion recipients gain employment through the community engagement waiver program.

According to the notice, the state expects to spend $184 million less over five years than it would without the program.

Why is Kentucky seeking a community engagement waiver program?

Earlier this year, lawmakers passed House Bill 695, which made sweeping changes to the state’s Medicaid program.

That included the controversial requirement for able-bodied adults to participate in a community engagement waiver program, including potentially requiring recipients to work 20 hours per week.

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The bill drew widespread support from Republicans and criticism from Democrats. Critics of work requirements say they’re “another way to cut coverage,” while supporters say it “demands that those who can put forth the effort do.”

A similar measure was previously introduced by former Gov. Matt Bevin in 2018, which would have required able-bodied adults to work or volunteer at least 20 hours a week or facing losing health coverage. That decision drew a lawsuit from health law advocates, and Bevin’s proposal was eventually blocked by a federal judge.

How can Kentuckians have input in the program?

The Department for Medicaid Services will hold two public forums on the program, one virtually and another in person.

The virtual forum will take place at 10 a.m. May 22. Find information for the call in the public notice at chfs.ky.gov/agencies/dms/Pages/Medicaid-SUD-1115-Waiver.aspx.

An in-person forum will take place at 10 a.m. May 23 at the Kentucky Transportation Cabinet auditorium at 200 Mero St. in Frankfort.

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Public comments can also be submitted by June 12 by email to KY1115CommEngagement@mslc.com or by mail to Kentucky Medicaid Section 1115 Comment, c/o DMS Commissioner’s Office, 275 E. Main St. 6W-A, Frankfort, KY 40621.

Reach reporter Hannah Pinski at hpinski@courier-journal.com or follow her on X, formerly known as Twitter, at @hannahpinski. 



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Kentucky Bill Filed to Legalize Fixed-Odds Wagering

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Kentucky Bill Filed to Legalize Fixed-Odds Wagering


The legalization of fixed-odds wagering is part of a comprehensive gaming and wagering bill filed March 4 with the Kentucky House of Representatives. 

Rep. Matt Koch, a Republican from Paris, and Rep. Michael Meredith, a Republican from Oakland, are sponsors of HB 904, which creates a form of betting that sets the payout odds at the time a wager is placed and those odds do not change.

Wagering on horse racing in Kentucky is now only pari-mutuel, the traditional form for the sport in which gamblers bet against each other and odds are determined based on how much is wagered on a specific bet—for example, win, place, or show—compared with the total money in the wagering pool.

With pari-mutuel wagering, the odds change as money enters the pool and has become a sore spot with many gamblers because these changes can be dramatic due to the introduction of computer-assisted wagering. CAW betting is a form of wagering that uses computer algorithms to formulate selections and then push those bets through to pari-mutuel pools, up to six bets per second in the final minute before pools are closed. This last-minute deluge of wagers can cause a horse’s odds to fall, for example, from 8-1 as they are loading into the gate to 3-1 as the race unfolds and the tote system catches up with calculating the late wagers.

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Offering fixed odds is seen as one solution and has already been adopted in New Jersey, Colorado, and in West Virginia last April.

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“This basically puts it in hands of the tracks to test the waters,” said Koch, who is the co-founder of Shawhan Place in Bourbon County. “As the gambling market continues to expand, we’re exploring ways to give tracks the flexibility to introduce new and engaging products. For many who enjoy wagering, consistency is key. They want the confidence of knowing a horse’s odds will remain steady throughout the race, allowing them to enjoy the experience to the fullest. However, we recognize the uncertainty that a new product brings and want to be particularly mindful of its potential impact.”

As part of the legalization of fixed-odds wagering, the bill creates a “purse stabilization fund” that will be supported by excise taxes and fees from fixed-odds wagering. Licensed tracks would pay 15% on the adjusted gross revenue of fixed-odds wagers placed on-track and via advance-deposit wagering websites and mobile applications. This fund will be used to supplement purses at live horse racing meets annually at an amount not to exceed 10% of the fund.

“This is similar to how other states manage the revenue from fixed odds and protects the traditional purse pools,” Koch said.

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Additionally, Koch said having outdated totalizator networks contributes to the frustration with CAW, so HB 904 includes a provision for licensed totalizator companies and licensed racetracks to accelerate the adoption of improved technologies for wagering systems and provide “commercially reasonable access to the betting odds for retail bettors by April 1, 2027.”

“Some of these totes are only updating every 30 seconds and that is contributing to the perception and frustration,” he said, referring to bettors seeing late odds changes. “Doing our research, we realize there are things we can do for tracks to update their totes and have those updated odds in seconds. We need to stay on top of the IT and that needs to be an ongoing deal.”

The bill also includes a prohibition against any track or association licensed to conduct horse racing, sports wagering, or fantasy sports being affiliated with or benefiting from any entity that offers prediction market contracts. 

Prediction market operators are a growing concern for the gambling industry because they have expanded from taking wagers on the outcome of future events, such as elections or new events, and are now including sporting events, such as horse racing. The prediction markets defend their business by claiming to take “contracts” and not “wagers.”

The threat of the prediction markets was addressed by Churchill Downs Inc. CEO Bill Carstanjen during a Feb. 26 conference call with investors and analysts and is the subject of a panel discussion this week during the National Horsemen’s Benevolent and Protective Association’s annual conference being held at Oaklawn Park.

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READ: Prediction Markets Have the Racing Industry’s Attention

Other provisions of HB 904 include:

  • After Nov. 1 of a calendar year, the Kentucky Horse Racing and Gaming Corporation may authorize additional racing dates or make changes to racing dates awarded if requested by a licensed association, supported by the applicable horsemen’s group and “deemed in the best interest of racing.”
  • Creates a new section that legalizes and puts the regulation of fantasy contests under the authority of the Kentucky Horse Racing and Gaming Corporation. Fantasy contests are simulated games or contests with an entry fee and awards or prizes established prior to the contest. Participants compete against each other and manage a fictional roster of actual athletes and obtain scores based on real-life performances. If adopted, all fantasy contest operators must be licensed by the state and adhere to regulations that include preventing fraud and money laundering, prevent underage participation, verify customers are geographically located in jurisdictions allowing fantasy contest participation, and comply with state audits and any complaints or allegations of prohibited conduct.
  • Sets the legal age to participate in sports betting, fantasy contests, and charitable gaming at 21 but keeps the legal age for betting on horse racing at 18.





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Northern Kentucky claims 4 titles at Class 3A indoor track state meet

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Northern Kentucky claims 4 titles at Class 3A indoor track state meet


The Kentucky High School Athletic Association indoor state track meet rolled on on Wednesday, March 4. One day after Beechwood claimed the Class 1A boys team title, three Northern Kentucky big schools combined for four individual state titles in Class 3A.

Cooper’s Paul Van Laningham won the 3,200-meter run in 9:09.49 and took second place in the 1,600-meter run in 4:07.88. It was a reversal of his results at the 2025 indoor state meet and earned him his fifth overall state title. He scored all of Cooper’s points, good for ninth place in the team standings with 18 points.

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Van Laningham’s teammate, Ava Dunn, got the day started with a shot put title, throwing the 8.82-pound ball 39 feet, 3.25 inches.

Simon Kenton’s Alexis Howard won the long jump with an attempt of 18 feet, 7.25 inches, then claimed the triple jump title with a distance of 37 feet, 4.25 inches. It is her second straight indoor long jump title and third overall as she also claimed the 2024 outdoor title. Taking fifth place in the 55-meter dash, she scored all 24 points for SK, finishing in a tie for eighth place. Cooper was right behind with 22 points.

Finally, Conner’s Avery Vanlandingham win the 800-meter run in 2:17.55, out-leaning North Oldham’s Millie Huang at the line.



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Arkansas women’s basketball blown out by Kentucky in season-ending loss at SEC Tournament | Whole Hog Sports

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Arkansas women’s basketball blown out by Kentucky in season-ending loss at SEC Tournament | Whole Hog Sports





Arkansas women’s basketball blown out by Kentucky in season-ending loss at SEC Tournament | Whole Hog Sports







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