FRANKFORT, Ky. — A major Medicaid overhaul bill has cleared its first legislative hurdle in Frankfort, as members of the House Appropriations committee approved House Bill 2 by a 14-to-4 vote.

The bill, sponsored by Ken Fleming, aims to transform Kentucky’s Medicaid program by strengthening oversight, reducing fraud, and aligning the system with new federal requirements.

Supporters say the proposal would improve health outcomes while ensuring taxpayer dollars are focused on the most vulnerable residents. The bill includes new accountability standards for managed care organizations, changes to eligibility reviews, transportation improvements for medical appointments, and the creation of a public healthcare transparency dashboard.

The legislation would also implement federally required community engagement — often called work requirements — for certain able-bodied adults, while exempting groups such as children, pregnant women, caregivers, and people with serious health conditions.

Opponents pointed out that the bill will raise co-pays for specialty services such as dialysis, cardiology and cancer treatment, as well as emergency room visits, on people who can least afford to pay them.

Health care providers, including Appalachian Regional Healthcare, voiced support for provisions aimed at improving access to care.

House Bill 2 now moves to the full Kentucky House of Representatives for consideration.