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Full Medicaid expansion to be implemented in Utah

Posted at 10:45 AM, Dec 23, 2019
and last updated 2019-12-23 19:24:51-05

SALT LAKE CITY — In a major policy shift, the state of Utah is implementing full Medicaid expansion to cover tens of thousands more of the state's most poor.

With approval from the Trump administration, the Utah Department of Health announced on Monday it would expand Medicaid to cover up to 138% of the federal poverty level ($16,753 a year in salary for an individual or $34,638 for a family of four). The federal government will cover 90% of the costs of these services, with the state covering the remaining 10%. More than 40,000 more people are now expected to be covered starting January 1.

The implementation of the policy is the "fallback" from the Utah State Legislature's decision to override a citizen ballot initiative voters approved last year to fully expand Medicaid. It also puts the state right back where it was with Proposition 3 last year.

"It took long enough, but Merry Christmas, Utah!" said Stacy Stanford with the Utah Health Policy Project, a group that advocated for Prop. 3. "Full expansion is a big, a big win."

Fearing that full Medicaid expansion would be a budget buster, lawmakers overrode Prop. 3 earlier this year with Senate Bill 96. It sought a series of federal matches and waivers (that were rejected), but also included full expansion as a fallback.

"This was the third step outlined in Senate Bill 96," Nate Checketts, the deputy director of Utah's Department of Health, said in an interview with FOX 13.

There are some additions. Checketts said the latest version of Medicaid expansion will have a work requirement and if people can get coverage through their employer, they will be required to seek that (with Medicaid helping their premium).

The work requirement could still face a legal challenge, but Stanford said she was ultimately happy with where they have ended up.

"We are pretty close to where we started. There’s a lot of question marks still. We have a work requirement which is bad news, we can talk about another day. But today we ended up pretty much with what voters asked for with some strings attached," she said.

On Utah's Capitol Hill, lawmakers seemed to be OK with where they have ended up.

"Today’s announced Medicaid waiver approval is evidence that the legislature’s decision to pass SB96 during the 2019 session was sound," House Speaker Brad Wilson, R-Kaysville, said in a statement. "The waiver will provide more Utahns with the coverage they need while saving Utah taxpayers millions of dollars in potential costs. We appreciate the willingness of the Centers for Medicare and Medicaid Services to work with the lawmakers in our efforts to craft a Medicaid program that meets the unique needs of our state."

Senate President J. Stuart Adams, R-Layton, was also happy with the decision.

"We have been working toward a Utah solution to expand Medicaid in a financially sustainable manner. Once again, Utah aims for a path that will help those most vulnerable while maintaining Utah’s respected, top nationally ranked way of life," he said in a statement Monday.

Democrats were happy but also critical of their Republican colleagues.

"Full Medicaid Expansion is good news for so many Utahns who have been waiting on the promise of access to affordable, quality healthcare. Our state’s leaders has repeatedly chosen to deny or delay that access, even overturning the will of the voters by repealing Proposition 3," Senate Minority Leader Karen Mayne, D-West Valley City, said in a statement. "I am glad that the wait will finally end on January 1, but I remain concerned that the work requirements being imposed may prove to be a barrier preventing some from being able to access the healthcare that they need. We need to focus on getting these people the healthcare that they need so that they are well enough to work and be productive."

But House Minority Leader Brian King, D-Salt Lake City, blamed his GOP colleagues and called for them to be ousted.

For Stanford, who organized protests against the legislature's replacement of Prop. 3, the victory was bittersweet. She said she was hoping lawmakers wouldn't keep tampering with Medicaid expansion in the 2020 legislative session.

"It’s like I want to celebrate and have a party but it’s also frustrating," she told FOX 13. "I don’t want to keep fighting."