Dunnigan, the majority leader of the House, is one of those whose fingerprints are all over the death of both Medicaid expansion, as provided in the federal Affordable Care Act, and Healthy Utah, Gov. Gary Herbert's serviceable alternative.
A palpable fear that President Obama's signature domestic policy success might actually work in Utah, combined with an irrational alarm over how much local implementation of any expansion of health care access might cost, moved Dunnigan, House Speaker Greg Hughes and an unknown number of other House members (all the discussions were in secret) to shoot down all previous proposals to help tens of thousands of Utahns who now lack the health care access taken for granted in every truly civilized nation on earth.
After three years of dawdling and delay, hundreds of millions of federal dollars passed up and an admirable criminal justice reform suddenly needing to be paid for, Dunnigan apparently has wearied of his image as a heartless ideologue who kills legislation, directly, and sick people, indirectly.
So he has, in the waning days of this legislative session, labored mightily and brought forth a mouse, House Bill 437.
It would leverage some $30 million in state funds — much of which would come from a new tax on hospitals — to draw some $70 million in federal money to expand health care access to maybe 16,000 souls who fall into some specific populations — the homeless, people leaving prison and those with serious mental health or substance abuse issues.
They are, in Dunnigan's eyes, those most in need of help. Of course, that's not true.
Those people may seem the most pitiable. And meeting their health needs would do a lot to help efforts to get more of the homeless off the streets of Salt Lake City and keep the promise of last year's treatment-over-prison Justice Reinvestment Initiative.
That's why such worthies as the mayors of Salt Lake City and Salt Lake County have joined with advocates for hospitals, the homeless, the mentally ill and those being released from prison to back HB437.
They have to support it because, right now, and for the foreseeable future, it's all there is.
The thing about health coverage is, you either have it or you need it. To say only the homeless, the incarcerated and the mentally ill need the state's help is simply false.
Dunnigan's bill would not do one solitary thing to expand coverage to some 40,000 (he claims only 20,000) Utahns who don't fall into those categories but still can't afford health insurance on their own and are not affluent enough to buy subsidized policies on the federal ACA exchanges.
Worse, and totally betraying any claims of fiscal responsibility, the Dunnigan plan is so out of keeping with federal incentives that, by limiting its benefits to so few, it leaves some $500 million a year in federal aid unclaimed.
That's half a billion a year that would, with real health care expansion, flow into the state, first to its doctors and hospitals, then to their employees, then to all the people they do business with, multiplying through the state economy over and over, to the benefit of all. Including, through higher tax revenues, the state.
The claim that the Legislature is taking this course because it doesn't want to add to the federal deficit is bogus. Even HB437 would draw some federal dollars. As do so many other things that no state politician would dare oppose, starting with Hill Air Force Base and running down through National Parks, federal oil and grazing subsidies and business and personal tax credits.
Dunnigan, Hughes and company have dug in their heels for three years. They have worn down the governor, the Senate, the hospitals, the LDS Church and advocates for the poor and the sick to the point that this practically worthless proposal actually looks good.
It is the shame of the Legislature and the governor that it is the best they can do.
It is the shame of every person in this state that they are likely to get away with it.