Utahns entitled only to Medicaid or the Children's Health Insurance Plan (CHIP) go through the state health department. Those receiving food stamps, welfare or child care subsidies can also apply for Medicaid through the Department of Workforce Services.
Moving the approximately 250 health department eligibility workers into Workforce Services was on a list of penny-pinching strategies explored. The consolidation would likely cost the state up front but promises savings down the road, though legislative analysts couldn't say how much.
Whether lawmakers will act on it anytime soon also is unclear.
Friday's meeting was an "information gathering" exercise, said Senate chairman Sheldon Killpack, R-Syracuse.
But the Medicaid task force has but one meeting left before the start of the 2007 legislative session. And the stakes are high.
Utah taxpayers shelled out $316 million on Medicaid this year, more than five times the amount spent in 1991. That's an average annual growth rate of 11 percent, far surpassing the rate of inflation or population growth.
If trends continue, Utah's share of the Medicaid bill will grow to $1.5 billion and consume 31 percent of the general fund.
"I don't see how we can handle that without some kind of tax increase on our citizens," said Rep. Mike Noel. The Kanab Republican wants to impose a cap to keep spending at 14.5 percent of the general fund.
"We need to hold the line," Noel said. "I know it's maybe a tough line, but sometimes expectations in people lead to lifestyle choices. If I know there's a safety net out there, I might not buy my own health insurance."
The state's $1.6 billion Medicaid budget props up 190 social welfare programs, including the child welfare system, and public substance abuse and mental health clinics. All these programs are under scrutiny.
But Friday's discussion centered on Medicaid's chief role as a health insurance program covering 265,000 low-income seniors, people with disabilities, pregnant women and children who otherwise would have no access to medical care.
Ideas floated include: steering Medicaid patients to low-cost drugs, reducing benefits for younger, healthier populations, and skimping on so-called optional services, such as dental and vision care. A proposal to change the way the state reimburses hospitals for outpatient care of Medicaid clients was on the agenda but not discussed.
Consolidating eligibility offices was perhaps the most concrete proposal broached.
Combining the two systems could save on staffing and overhead, said Stan Eckersley, fiscal analyst who estimates about 12 percent of CHIP clients have two eligibility workers, and another 20 percent of all Medicaid cases get passed back and forth between agencies.
One challenge: each agency pays its employees on different scales.
But now may be the best time to rethink the way applications are screened. In 2008, the state is launching a new $70 million computer system for handling applications, the largest software project in Utah's history.
kstewart@sltrib.com
