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Lawmakers snub governor’s Healthy Utah plan, recommend modest Medicaid expansion

First Published      Last Updated Dec 18 2014 09:37 pm

Health reform » Lawmakers snub Herbert’s plan, pick two other options covering only “medically vulnerable.”

Utah lawmakers dealt a setback to the governor's Healthy Utah alternative to expanding Medicaid Thursday.

The Legislature's Health Reform Task Force chose not to recommend the plan to the full Legislature, instead picking two other options to cover many fewer Utahns, and only if they are "medically vulnerable."

Rep. Jim Dunnigan, R-Taylorsville, called it a "good, measured approach."

Dunnigan is co-chairman of the task force and proposed recommending options that would cover between 12.5 percent and 20 percent of those below the federal poverty line — but only those who are mentally ill, addicted, disabled or too sick to work.

Both options would provide health care for a fraction of those who would be covered under Healthy Utah.

"If it works, we can always advance it further and cover more," Dunnigan said, winning the votes of the Republicans on the task force who said they worry about the long-term costs of extending Medicaid benefits.

The move surprised and disappointed the governor's point man on Medicaid expansion, David Patton, executive director of the Utah Department of Health.

"They're being shortsighted," said Patton, noting that the task force's options are much more costly than the governor's plan for six years and they would cover much fewer people.

The task force's proposal to cover only some medically vulnerable or frail people "is really not vetted," Patton said. "It's not thought through yet."

Patton said he's still optimistic that the full Legislature will embrace Healthy Utah, which he described as the most financially responsible plan, and one that would cover the highest number of the poor.

Sen. Brian Shiozawa, R-Cottonwood Heights, a physician, was surprised by the vote. He and Democrats on the task force had wanted Healthy Utah to be among the recommended options.

He said the task force's recommendations defy logic because they are more expensive for several years and cover far fewer people than Healthy Utah would.

It's going to be a rough road for the governor's plan, Shiozawa said, given the lack of support from Dunnigan, who is considered the key lawmaker on health care reform.

Dunnigan, who accompanied Herbert to Washington two times as the governor negotiated with the U.S. Department of Health and Human Services, blasted the feds for not allowing a higher match rate if the state expands Medicaid only to those whose incomes are at or below poverty levels.

By agreeing to expand coverage to those up to 138 percent of poverty, the governor was assured a higher match from the feds. It starts at 100 percent and drops to 90 percent in 2020 and beyond. Under Dunnigan's options, the federal government would pay 70 percent, which is the current match rate.

Dunnigan called the Affordable Care Act a "convoluted scheme" that the feds are foisting on Utah.

"If they (the federal government) want to really cover people, who don't they give us the enhanced match?" he said.

Under the task force's recommended Option 1, 10,300 medically frail people below the poverty level would be covered at a cost to the state of $28 million in 2021, Dunnigan said.

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