Medicaid expansion plan proposes taxing medical providers to help in coverage gap

Posted at 11:06 PM, Oct 06, 2015
and last updated 2015-10-07 09:34:35-04

SALT LAKE  CITY -- Hundreds packed the State Capitol to learn more about a proposed Medicaid expansion plan, Tuesday.

It was the first time lawmakers publicly presented their Utah Access Plus plan, the latest attempt at filling the coverage gap for more than 100,000 Utahns.

“If that is the only thing that will get the other chamber, the House, involved and to agree to it, that for the greater good I’m willing to support it,” said Sen. Brian Shiozawa, R-Cottonwood Heights.

Shiozawa helped craft the failed Healthy Utah Plan. For the last few months, he’s been working on an alternative solution with other lawmakers, together known as the Gang of Six.

“I’m conflicted on this, clearly,” he explained.

The conflict stems from the division that has already occurred within the medical community since details of the plan were released last week. Under Utah Access Plus, medical providers would be taxed in order to generate the funding to support an expansion.

For example, physicians would face a $797 annual medical licensing tax to help generate approximately $9 million by fiscal year 2021.

Other taxable parties include hospital, therapists, pharmaceutical companies and nurses. The tax allows the state to receive a federal match, which would generate $450 million to cover the cost of insurance subsidies for people making less than 138 percent of federal poverty level.

“To tax, to further tax those individuals, who are already at their own cost providing these services, is a malfeasance,” said Dr. Trenton Jones, who testified in opposition to the plan.

According to the Utah Medical Association, a survey of physicians around the state found that 99 percent of the 2,000 respondents oppose the proposal.

“If the state decides to provide a service or program to the citizens of Utah, then we don't believe you should tax those who are providing the service,” said the association’s CEO, Michelle McOmber.

However, many countered that some kind of plan was better than no plan.

The Utah Nurses Association, whose members would face a $1.49 fee, supported the proposal, arguing their patients have suffered for too long. It was a sentiment argued by many others.

“Only 14 states have a higher uninsured rates than Utah. Three years is long enough to find a Medicaid expansion solution,” said RyLee Stowell, a policy analyst for Utah Health Policy Project.

Stowell handed out stories of Utahns who fall in the coverage gap and struggling to survive in it. She asked lawmakers to think about them as they make their decision.

"Without insurance and without medical care I would be dead. So, I strongly support this bill,” said one local resident.

The testimony carried well over the allotted three hours for the meeting. The Health Reform Task Force extended the window for an extra hour, allowing everyone to be heard.

However, at the end, it was unclear what future the plan really has in the state.

“I don't know what's going to happen between now and the next week and the week after that,” said House Majority Leader Jim Dunnigan, R-Taylorsville.

Next week, the House caucus will meet to take a straw poll vote on the plan. It will need 38 votes to move forward.

"I don’t know what my caucus will be next week,” explained Dunnigan. “I really don't know."

If it doesn’t gain enough support, Shiozawa is already thinking of an alternative, one that shifts the costs to hospitals.

“They will make, as you heard in there, significant amounts of money from the uncompensated care,” he explained. “And I believe that we could support the Medicaid program responsibly if they took the burden.”

The caucus will meet October 13.