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Op-ed: Utah should expand Medicaid for a lot of reasons
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated.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.

Health care reform is a topic that continues to dominate the headlines in Utah and across the U.S. Whether it's a conversation about the recent government shutdown, signing up for health care insurance through the government website or tuning in to the ongoing debate about whether Utah should expand its Medicaid program — health care is the issue of the day.

And it will likely continue on that trajectory in the coming months as Gov. Gary Herbert decides what Utah's future Medicaid landscape will look like.

The governor's decision is an important one for all Utahns. Why? The Affordable Health Care Act, also known as Obamacare, requires people in the U.S. to get health insurance by 2014 through private insurance from their employer or self-purchased, or through public programs like Medicaid, for those eligible. The law has prompted conversations in many states, including Utah, on how to expand Medicaid to meet the requirements of the Affordable Care Act.

States may choose to offer health care benefits to thousands of new beneficiaries coming into the health care system in a variety of ways, including through the traditional Medicaid program or through a health insurance exchange. States have other "partial expansion" options under the ACA, which are being explored in Utah by legislators, state leaders and community workgroups — conversations which I have been a part of in my role as CEO of University of Utah Hospitals and Clinics.

Through the lens of my own organization and through conversations with my colleagues at other hospitals across the state, I believe that developing a Utah-specific option for expansion is the right choice for our state for several reasons.

Perhaps the most important element for expansion is the human aspect that applies to the conversation: There will be fewer uninsured people and significantly less spending on uncompensated care (care for which doctors, clinics and hospitals are not paid for) and public assistance programs. With expansion, a significant number of Utahns will have health insurance. Not only will this improve access to health-care services for thousands of low-income people, it will also save Utah over $814 million in uncompensated care costs and $39 million in public assistance costs over the next decade.

Utah businesses would also see many benefits to Medicaid expansion. An expansion would help Utah businesses by reducing cost shifting —a practice in which hospitals must either absorb the costs generated by uncompensated and under-compensated care or shift those costs to private insurers. When hospitals shift costs to private insurers, insurers pass on the added expense to Utah businesses and, ultimately, their employees in the form of higher premiums. Expansion will help reduce this "hidden health care tax" by significantly reducing the amount of uncompensated care hospitals provide.

An expansion would also help Utah businesses by bolstering Utah's economy. According to the Public Consulting Group's State of Utah Medicaid Expansion Assessment, expansion would add more than $2 billion to Utah's economy, create 3,000 to 4,000 new jobs, and increase state and local tax revenue by over $154 million by 2023. Such strong economic activity would help Utah's businesses thrive.

You can pick any or all of these reasons — as well as many more not outlined here — for why Medicaid expansion in Utah is a wise choice.

Whether it's economics or simply considering the well being of so many people in our communities, embracing Medicaid expansion is an option that will benefit our state for years to come.

David Entwistle is CEO of University of Utah Hospitals and Clinics. He also serves as chairman of the Board of Trustees for the Utah Hospital Association.

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