Both mathematics and humanity are on the side of Utah joining the 24 states that have already decided to take the federal government up on its offer to expand Medicaid health coverage to many thousands of residents who would otherwise remain uninsured and, because of it, present an even larger burden to the state's health care system and its taxpayers.
Clearly, the only excuses for not expanding Medicaid to an estimated 150,000 Utahns almost entirely at federal expense are a sad lack of concern for low-income families or a fear of admitting that there is anything to like about the Affordable Care Act.
Even as advocates for the poor and working families make the argument that it is positively medieval for Americans to go without basic health care coverage, Republican governors in Arizona, Nevada, Ohio and Florida have done the math and figured out that extending Medicaid to more low-income people makes sense. Not only will the additional case load be funded 100 percent by the federal government for the first three years, and at 90 percent thereafter, but state and local governments, employers and individuals who either pay for their own insurance or just pay out of pocket for their care will all benefit.
That's because we will all be part of a system where, nationally, millions more people will have their health care covered. That means they will not have to rely on expensive emergency room care or leave the doctors and hospitals that do care for them holding the bag for unpaid services. And the rest of us won't see those costs passed along in higher prices, insurance premiums or taxes.
States will pay less for medical care for prison inmates. Counties will pay less for mental health care for their low-income residents.
A quick run through the numbers by the Utah Legislature's fiscal analysts shows the state will save $5 million in fiscal 2014 and $16 million in 2015 if it agrees to full Medicaid expansion. And that doesn't even count the savings financial and human to be realized by Utah households.
Some of Utah's leaders may have to hold their nose and swallow hard. But Medicaid expansion is good for everybody, and they should go along with it.