Lawmakers provide options on how to cover ‘Medicaid Gap’

Posted at 10:06 PM, Feb 25, 2014
and last updated 2014-02-26 00:06:17-05

SALT LAKE CITY -- In Utah, there are about 55,000 people who fall into what’s known as the “Medicaid Gap.” It’s a hole created in states that chose not to expand Medicaid and one that state lawmakers can’t figure out how to close.

“We know already that Medicaid in many, many ways is a broken system,” House Speaker Becky Lockhart, R-Provo.

Debate over how to provide coverage for the Utahns who cannot afford it has led to varying solutions from lawmakers.

On one side, speaker Lockhart is supporting an alternative to expanding that doesn’t use federal dollars, while on another, Sen. Brian Shiozawa, R-Cottonwood Heights, has come up with his own federally funded solution.

Gov. Gary Herbert also announced plans on Tuesday to unveil his own proposal this week.

“That’s when we make the best decisions,” Lockhart said. “It’s when we have all the information. So, all the voices are welcome. All the proposals are welcome.

Lockhart’s plan, “Access Utah,” would reject hundreds of millions in federal funding to instead use state dollars to subsidize insurance for Utahns who fall in the gap.

“This is a two-year pilot program because we know in 2017, under the ACA, there are options for states to look at block grants and other ways in addressing this issue,” Lockhart said.

An early estimate put the cost to the state at about $35 million annually. The plan was approved by a house committee on Monday.

“What we do by accepting the federal money in expanding Medicaid is not only expand a socialized system of medicine, but also continue to perpetuate the problems that we already have in Medicaid,” Lockhart said.

But Sen. Shiozawa disagrees.

He is proposing a partial Medicaid expansion that would seek a 90/10 federal funding match to cover Utahns in the gap. It would likely cost the state less than $100 million over a decade.

“I think this plan that we have in comparison is a great compromise,” Shiozawa said. “It does a complete coverage of the coverage gap. It uses a modest amount of state funding, far less than the House plan, and still leverages a significant amount of money from the federal government.”

The senator’s plan seems to align somewhat with what the governor hopes to do with Medicaid in the state, which involves accepting federal funding.

“I have had a chance to talk to Sen. Shiozawa, and he's a doctor and he understands the costs of medicine,” Herbert said Tuesday. “I'll be prepared by the end of this week to rollout what I think we should be doing when it comes to dealing with these people, who are falling through the safety net, that need some assistance when it comes to access to healthcare and insurance."