This is an archived article that was published on sltrib.com in 2017, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Through all the debate, all the deadlock, all the disrespect for experts, all the disregard for the aged, the infirm and the struggling, all the pleasure Utah lawmakers took in thumbing their noses at the president of the United States and turning their back on their own governor, the total kept growing.

The clock kept ticking. They money kept going somewhere else.

As this is written, the total bill was inching up on $1.011 billion. That's billion. That's the amount — at $797,000 a day — that the state of Utah has walked away from because it callously refused to join with 32 other states (including D.C.) to accept the expansion of Medicaid that was supposed to be part and parcel of the Patient Protection and Affordable Care Act.

By first rejecting the offer made by President Obama, and then dissing the kiss-up-to-the-private sector, invented-here alternative offered by Gov. Gary Herbert, the Legislature killed every idea put before it.

Herbert, supported by the whole of the health care intelligentsia and caring organizations of the state, argued that passing up all that money was not only an act of cruelty toward those who would have finally come close to First World levels of health care access but also an economically foolish move that ignored the potential for some really serious job creation in the state's crucial, high-paying, can't-be-outsourced-or-off-shored health care sector.

You might think that a political class that is all about sucking up to job-creators, as long as they are coal mines or Air Force bases, would see that and ask where they should sign.

But the Gare Bear just doesn't have enough arm-twisting, log-rolling, so you want to build a new state prison Lyndon Johnson in him to make lawmakers see the economic bonanza Medicaid expansion would be for the state as a whole.

The undeniable — and undenied — fact that the undeserving poor of Utah might benefit in the process was a deal killer.

Finally, pressured by their own admirable desire to put fewer drug abusers or mentally ill people in prison, and by the need to finally face the epidemic of homelessness in Salt Lake City, they cooked up a fraud of a plan aimed at providing some care to those small but desperate populations.

Actually putting the program in place, getting all the federal dollars that would cover the bulk of the cost, required a huge waiver from ACA standards. Because it amounted to an insult, both to the administration and to the working poor of Utah, the Obama administration wasn't buying it.

So little for so few, when so many are in need, amounted to offering a single salted peanut to a person who has had nothing to eat or drink for days. So, of course, official Utah had reason to think it would appeal to the Trump administration.

And, just to boost their chances with the new crowd in Washington, Utahns made the proposal even worse. They added lifetime coverage caps, work requirements — for people who either already work minimum-wage jobs or are incapable of holding a job — and placing additional bureaucratic obstacles in the way of the people among us least able to surmount them.

Of course, another thing that changed with the election was the fact that the official excuse for not expanding Medicaid in Utah — the risk that the feds might yank the billions of dollars it promised to pick up at least 90 percent of the cost — may soon prove true.

It may come by the passage of the Republican bill that breaks all of the new president's promises to preserve Medicaid and improve the coverage offered by the ACA. A bill that would not only roll back Obamacare but also fulfill Speaker Paul Ryan's boyhood fantasy of repealing the 20th century, or at least the parts of it that provided decency for those who can't afford to buy it for themselves.

Or, if that bill doesn't pass, it may come as the result of a drip, drip, drip of budget cuts and broken promises that would fulfill the otherwise groundless prophecy of the ACA collapsing on itself.

Then those of us who argued that the nation would never be cruel enough yank that funding away — because it never had before — will be proven wrong.

If that happens, Utah indeed won't be in the same boat with the states, red and blue, that took the expansion money and may now face the choice of taking coverage away from millions or busting their own budgets trying to make up the difference themselves.

But that won't change the fact that the state of Utah, deliberately and with malice aforethought, walked away from $1 billion that would have eased suffering, prevented bankruptcies, created jobs and saved lives. And, worst of all, got to say, I told you so.

George Pyle, the Tribune's editorial page editor, was never pessimistic enough to see this coming. gpyle@sltrib.com