[In honor of John Cleese and his appearance this Sunday with “Monty Python and the Holy Grail.”]

This scene is sickening:

As Seema Verma talked to reporters in Salt Lake City on Monday, Taylorsville Republican Rep. Jim Dunnigan abruptly took several steps toward her and held up his hand for a high five. She slapped it. Not to be outdone, Gov. Gary Herbert did the same. It was a celebration of the federal government’s recent approval of Utah’s Medicaid waiver, meant to cover 4,000 to 6,000 poor adults without children. Verma leads the Centers for Medicare and Medicaid Services, which approved the deal. But the gesture also showed how Herbert and conservative lawmakers are thrilled to see a new-look Medicaid program under President Donald Trump, one they hope gives states like Utah — which refused to expand Medicaid to tens of thousands of Utahns under President Barack Obama — more flexibility on how to spend federal health care dollars.

As we said last week:

The best bad news about Medicaid in Utah — Salt Lake Tribune Editorial

The scene Wednesday was very much like one where rescuers had rushed to a coal mine collapse or a crash involving a school bus. After quickly determining that maybe 20 people were already dead, they turned to the urgent task of rescuing two people who were still clinging to life and, after many hours of intense but delicate efforts, succeeded in setting them free. The joy and celebration felt at the success of that rescue is genuine and well earned. But it comes at the expense of ignoring what was lost. As of Wednesday, the state of Utah’s decision to refuse the expansion of Medicaid under the original Affordable Care Act had cost Utah taxpayers, health care providers and patients a total of $1.1 billion since the offer was first made in 2014. That water over the dam, elected officials and activists of all levels and stripes were understandably elated that the federal government announced its approval Wednesday of the state’s plan to debase itself to accept a tiny fraction of that amount to provide health care services — specifically substance abuse and mental health treatment — mostly to some 6,000 individuals who are homeless and/or in the criminal justice system.

The Utah Medicaid expansion deserves only scorn — Sen. Jim Dabakis | For The Tribune

... Full expansion would have used $610 million Washington dollars and $67 million state dollars a year to cover 134,000 people. The waiver takes $70 million D.C. dollars and adds $30 million in Utah taxpayer’s dollars to cover just 6,000 people. Under full expansion, Utah taxpayers chip in 10 percent of the cost while, under the waiver, the state’s share is 30 percent. ...

Utah’s top elected officials, and a very important personage from the Trump administration, are literally celebrating the fact that they have crafted a version of Medicaid expansion, made possible by the very Affordable Care Act they despise, that will serve a fraction of a fraction of the Utahns who are in desperate need of health care.

They tiny number Utah will reach with this plan are the ones who, if they aren’t cared for, will get sick and die on the street, discomforting those who want very badly to pretend nobody really suffers from a lack of access to health care, bothersome to those who see the homeless as something lowering the property values of the city’s next boom neighborhood.

The rest of you, those with cancer or kidney failure or cystic fibrosis, who aren’t lucky enough to have a good employer-based plan, you are just out of luck. Even if you aren’t one of those who dies, you are likely to be one of the millions of bankruptcies caused by medical bills. A thing that simply does not exist in any nation we would consider civilized.

Our elected officials say this is an example of how states should be allowed to decide for themselves how to provide health care access to their residents.

Actually, it is proof that they shouldn’t.

Meanwhile, this — which has bipartisan support — might help.

Salt Lake County to sue Big Pharma over the toll of opioid addiction — Jennifer Dobner | The Salt Lake Tribune

Bowing under the weight of Utah opioid deaths, Salt Lake County officials on Monday announced plans to sue the pharmaceutical industry over the havoc the drugs have wreaked on people and public services. The lawsuit would seek financial damages — possibly tens of millions of dollars — sufficient to repay the county for criminal justice, drug treatment and social service costs incurred by addressing the widespread damage that comes with opioid addiction. ...


The revised Senate tax bill will repeal the individual mandate, according to multiple reports. Repealing the mandate — which is the gear that makes the Affordable Care Act tick — would save more than $300 billion over 10 years, but only because millions fewer Americans would have health insurance, according to the Congressional Budget Office. It also means higher premiums, because the younger, healthier people who have an incentive to buy insurance rather than pay the mandate would be expected to exit the market while the sicker people stay in.

Surprise! Obamacare Enrollment Is Actually Rising — Megan McArdle | Bloomberg View

... the last year of high-profile attempts to repeal Obamacare may have reminded folks that Obamacare exists. That seems like a crazy theory to anyone who follows politics closely — but if you go venture outside certain wonk-dense enclaves, you quickly realize that most people don’t follow politics that closely, or indeed, much at all. Many people may have been too wrapped up in their daily lives to pay much attention to open enrollment, but having seen “Obamacare!” splashed across the news for six months, finally decided to check it out when the exchanges opened for business. ...
(Francisco Kjolseth | The Salt Lake Tribune) Tribune staff. George Pyle.