SALT LAKE CITY -- On Jan. 1, the Affordable Care Act's most sweeping provisions go into effect, though in Utah what that means is at least 50 percent up in the air.
That's because Utah is among a shrinking number of states yet to decide whether it will accept federal funds to expand Medicaid to anyone at or below 138 percent of the federal poverty rate.
Gov. Gary Herbert heard several options presented at his Health Care Summit held in a Salt Palace ballroom filled with stakeholders in the health care industry.
Among the options: simply accepting the money and expanding Medicaid, accepting all or part of the money and creating a new system helping people pay for insurance in a public/private partnership, or rejecting the money and working at streamlining a system of charity care.
"Is it a moral issue? do we help people who have health care needs? Absolutely," Herbert said, clearly struggling with the conflict between available resources for health care and his principled opposition to Obamacare.
"Is it a moral issue that we don't shackle our children and grandchildren with debt that they can't pay back that leads our country into insolvency, that kills the goose that lays the golden egg, that leads us toward insolvency? That's at least got to be part of the discussion," he said.
But others in attendance believe the governor's equivocation is stalling care they need.
Sherylin Horrocks is dealing with late-stage liver failure resulting from a disease called systemic sclerosis. Horrocks said attending the conference will take so much energy she'll be in bed for days afterwards, but she said she's been rejected by Medicaid because her husband's railroad retirement and disability make her ineligible.
"My husband's very angry over this thing,” she said. “Very, very angry. I'm very, I don't know if I'm hurt or angry. Maybe a little of both.”
Horrocks' family practitioner, Dr. Ray Ward of Bountiful, paid her $150 admission, saying the conference needed attendees who might benefit from a Medicaid expansion.
"I just hate it when the system is set up where I know what that person needs but I don't have the ability to get it to them," Horrocks said, "and I say 'sorry bad luck for you, I can't get what you need.'"