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Medicaid, the Legislature and genetics
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Every Utahn should be required to serve time on the Legislature's Joint Appropriations Subcommittee for Social Services. Time spent with the state's social service agencies and their clients ought to qualify as church attendance. No other legislative assignment runs committee members head-on into the ethic of what a certain man from Nazareth called "doing unto the least of these, my brethren."

The proposed Medicaid expansion is a useful case in point. The Affordable Care Act gives Utah an opportunity to bring nearly 50,000 uninsured Utahns into Medicaid. For the first three years, the feds pay for everything, and then the program gradually reverts to the still-generous three-quarters federal match. Put another way, Utah would receive $3.6 billion over 10 years for an investment of $239 million.

The human condition and all of its tragedies, heartbreak, misery, unfairness and desperation spill into the Social Services Committee hearing room, where it lands face-to-face with the governing class.

Legislators, for the most part, live on a completely different planet. They live in comfortable homes, they don't miss meals, and every part-time one of them is covered by a gold-plated health insurance plan not available to any other part-time public employee. And if they serve a few terms, they and their spouses get free health insurance for life, above and beyond Medicare. Nice work if you can get it.

Life isn't fair, and it's often inexplicable. It's hard to be confronted, day after day, with lives so bereft of anything remotely close to high on the hog, circumstances even where hope is a luxury. Babies are born without arms, and brains fail to develop normally or are damaged in ways that leave a child helpless. Injuries leave people unable to work. Tomorrow can bring a life-changing tragedy to any of us, and most Utahns are one or two paychecks away from having no health insurance.

Those who seek the committee's favor might have an easier time of it if the committee met on Sundays, after church. The committee's weekday work, however, does not want for sermonizing from the pulpit. One of the committee's co-chairs, in a City Weekly interview, suggested that it would be sort of immoral for Utah to opt into the Medicaid expansion program because, "We take pride in ourselves, and taking a handout like the expansion is not something that's in our genetic makeup."

It would be a quibble to argue that the chairman's own taxpayer-funded health insurance is akin to a handout; technically they voted it for themselves.

St. Matthew aside, for some Republicans, the moral dimensions of the Medicaid expansion warrant a thumbs-down because the federal government "has never been in such a hole." To these Republicans, Utah's opt-in would add unforgivably to the federal deficit, and taking the money would be irresponsible.

Maude Norman from Bountiful had the temerity to ask the committee, "We accept federal money for freeways, so why not Medicaid?" That simple question goes right to the heart of the issue, and it illuminates the artificiality of all of the "good" reasons for not doing the smart and right thing unto "the least of these," who were, as it happened, sick.

This year, Utah, evidently against the best judgment of our fiscally responsible legislators, is collecting more than $3.5 billion in tainted cash. Legislators and the governor welcome federal money for roads with open arms. The National Guard is 98 percent federally funded and all of the hardware is federal.

If the Legislature is serious about saving the federal government from itself, if we are "self-sufficient" down to our DNA, how did all of this awful federal cash get into our pockets? It's hard to blame it on the Democrats, because the state — "the best managed state in the nation" — has been dominated by Republicans for 35 years.

It isn't really the concept of federal money that Republicans circa 2013 choke on. Federal money to buy things is just fine; it's federal money to help people that is so difficult to swallow. Roads are great, so are dams, water projects, university research grants, disaster relief and airports. There is a swath of "rural" Utah that has state-of-the-art telephone and Internet access solely because of low-cost federal loans.

But money for education and health care? It's socialism at the door and the Red Menace at the curb. Except that, to vote "yes" on your own health care insurance and "no" to cover Utahns in desperate need, is the kind of hypocrisy about which the Nazarene had other pointed things to say.

David R. Irvine is a Salt Lake attorney who served four terms as a Republican member of the Utah House of Representatives. He lives in Bountiful.

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