Herbert, who surrounded himself by a phalanx of medical, insurance, business, religious and charitable leaders at a news conference Thursday, said Utah should provide concrete help in the face of such discouragement.
"These are our neighbors, our friends and our family members," said the governor. "Turning a blind eye and doing nothing is really not the Utah way."
The governor faces a skeptical Legislature, though, especially after he and lawmakers learned this week that any alternative to expanding traditional Medicaid will cost millions more than previously thought.
That's because of a 40 percent increase in the state's estimate of the number of people in the coverage gap who would seek coverage, up to 63,000 from the 45,000 predicted in a 2013 state-commissioned study. A study led by University of Utah economist Norm Waitzman several months ago pegged the number at 77,000.
These are people in the so-called coverage gap, who don't qualify for Medicaid because they don't have children, are not pregnant, disabled or seniors or who have children but earn from 49 percent to 100 percent of the federal poverty level. Those in the gap don't qualify for health insurance subsidies in the federal marketplace.
The Affordable Care Act had envisioned every state would expand Medicaid to cover those people, but the Supreme Court let states opt out of expanding Medicaid, and that created the gap in states like Utah, that did opt out of traditional Medicaid expansion.
Herbert's Healthy Utah plan, negotiated over several months with the U.S. Department of Health and Human Services, would help adults in the gap and those earning up to 138 percent of federal poverty levels buy private health insurance plans.
Those whose employers offer health insurance they can't afford would get wrap-around plans that would help them pay the premiums, co-pays and deductibles of employers' plans.
Herbert's plan goes further than the coverage gap because that brings a much higher match from the feds, starting at 100 percent in 2016 and falling to 90 percent in 2020.
Healthy Utah would be a three-year pilot program. The state's share would rise from $4.6 million for half a budget year in 2016 to $80 million to $90 million per year by early in the 2020s. That's steeply higher than the previous estimates, which had the state saving money for the first few years.
If Utah extends coverage only to those in the gap, HHS will chip in only 70 percent, which is the share they now provide for Utah's Medicaid program.
The Legislature signaled Thursday that the governor's plan won't be the only thing on the agenda when it convenes for the 2015 session on Jan. 26.
"The question of Medicaid expansion isn't just going to be a yes or no to Healthy Utah," said Speaker of the House Greg Hughes, R-Sandy.
Rep. Jim Dunnigan, R-Taylorsville, sketched out four other options to the Legislature's Health Reform Task Force on Thursday. An insurance company owner and House majority leader, he is the co-chairman of the task force.
None of the four would be as generous with low-income people as Healthy Utah, and all would cost millions, he noted. Like Healthy Utah, all the legislative plans would give poor people help paying for private health insurance plans and they'd see similar co-pays, Dunnigan said later.