Photo: Bill Pugliano (Getty Images)

Merry Christmas, happy New Year, and if you live in Kentucky, good luck going to the doctor.

Starting Jan. 1, Kentucky will require all patients to make a copay when visiting the doctor, regardless of income or financial status. The mandate is part of the new set of state healthcare rules, an overhaul championed by Republican Gov. Matt Bevin. As detailed in a piece from the Louisville Courier-Journal, while most managed care companies waived copays for Medicaid patients in the past, Bevin’s new rules will forbid it.

While this results in what sounds like small amounts—$3 copays for most visits to the doctor—Bill Wagner, the CEO of a chain of community clinics, told the Journal that roughly 4,500 homeless Kentuckians will be affected by the new mandates. The majority of these folks are homeless or dealing with mental illnesses that leave them unable to work or seek an income. Wagner and a slew of other health officials spoke out against the mandatory copays, saying that they will only further discourage those citizens with low or nonexistent incomes from accessing the American healthcare system.

The new healthcare restriction have been hotly contested all year long. In June, a federal judge rejected Bevin’s plan to tack on a work requirement to the state’s Medicaid program, though that stipulation is still pending. The details around the work requirement have been declared by both Kentucky citizens and health care officials as unclear; per the Journal, Bevin’s administration decided that only those declared “medically frail” could skip out on the 80-hour per month work or volunteer requirement. Prior reporting from the Journal detailing the unpopularity of Bevin’s new healthcare plan revealed that, should the work requirement change actually go through, nearly 100,000 citizens will be dropped from Medicaid in the next five years.

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While the copay change is scheduled to go into effect at the outset of 2019, other systemic overhauls, such as the work requirement mandate, will arrive in April. This includes the cutting of basic dental and vision coverage from the state’s Medicaid plan. Instead—in maybe the most Hellworld-esque part of this entire mess—Kentucky residents will be reduced to trying to earn points to pay for their dental and vision care through what’s being called the My Rewards program.

Bevin being an idiot and a monster isn’t exactly anything new. But the fact is that now, with said monstrous idiot controlling a firm grip on his state legislature, scores of poor Kentuckians are going to die in 2019 because their asshole governor and his cronies want to, per the Journal, “get people more engaged in their health care and become familiar with cost-sharing.” Instead, how about we just give people healthcare?