This is an archived article that was published on sltrib.com in 2015, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
When Heather Hirsche of Lindon sent her daughter to Lake Powell with friends last month, she worried about her safety, and the possible price of an accident.
One injury away from financial devastation, Hirsche and her daughter fall into the "doughnut hole" — the nickname for the health coverage gap that leaves thousands of low-income Utahns uninsured.
Utah Democrats told Hirsche's story and others' at a news conference Tuesday in an effort to prod Gov. Gary Herbert and Republicans in the Legislature to reach a resolution before the next legislative session starts in January 2016 — and to do it out in the open, rather than behind closed doors.
Democrats blame the so-called "Gang of Six" — including Herbert, Lt. Gov. Spencer Cox and GOP lawmakers — for failing to reach a deal to expand Medicaid under the Affordable Care Act. The group missed a self-imposed July 31 deadline. And although the gang's members say they hope to reach a deal before the 2016 Legislature opens, Democrats worry that may be too late for some Utahns who don't make enough to pay for subsidized health care, but make too much to qualify for Medicaid.
While the Legislature is holding a special session Wednesday to discuss the prison relocation, Medicaid expansion is not on the agenda.
"Economic development is taking priority over the lives of our citizens of Utah," said Utah Democratic Party Chairman Peter Corroon. "All we can do is pray that there will be [a special session]."
Republicans counter that they are actively working on a compromise — including meeting with U.S. Health and Human Services Secretary Sylvia Burwell when she was in town last week.
"The G6 has been working nonstop and has made tremendous progress toward a proposal that covers those most in need, promotes self-sufficiency and protects our limited state budget by asking financial beneficiaries of expansion to share the state's risk," said Chuck Gates, communication director for the Utah House of Representatives. "This coming proposal will be simple, sustainable, equitable and accountable."
That could be true, Democrats say, but the public wouldn't know it, because the negotiations are going on in secret.
Those invited to health care discussions in the past have been cut out over the past six months, said Rep. Rebecca Chavez-Houck, D-Salt Lake City.
"Previously, affected stakeholders, from county behavioral health folks to physicians that try to serve Medicaid patients every day, have been part of the discussion," Chavez-Houck said, "and those discussions have been held in the light of day."
Now, she said, she does not know what's in the plan. And she worries Republican negotiators might be willing to accept high premiums and copay prices that still could edge out low-income Utahns.
"The devil is in the details," she said.
Stories of Utahns in the gap will be showcased in a new documentary film, "The Donut Hole," made by two University of Utah medical students.
"As medical students, we were very disappointed when the governor's Healthy Utah plan was rejected in committee this last session," said Spencer Merrick, one of the film's creators.
Merrick and co-creator John Sanchez said they wanted to share the stories of Utahns in the gap.
"What does [the coverage gap] mean for a person's health, their happiness, their ability to work?" Merrick asked. "How do they fit the stereotype of a Medicaid patient?"
The film also highlights Carol Frisby, who died in July of colon cancer after forgoing a recommended colonoscopy because she was unable to afford the procedure out of pocket and was not covered by the Primary Care Network (PCN).
Brent Frisby, Carol's husband, said he wants to "carry on her legacy to help people so they don't fall through the system."
"It's for people like Brent that we're doing this," Chavez-Houck said.
"Donut Hole" is screening Sept. 1 at 7 p.m. at the U.'s S.J. Quinney College of Law.
Twitter: @amymcdonald89