The bargaining position that Utah Gov. Gary Herbert is in as he dickers with federal officials over his "Healthy Utah Plan" is reminiscent of the famous 1973 National Lampoon magazine cover. The photo of a pistol pointed at a dog and the caption, "If You Don’t Buy This Magazine, We’ll Kill This Dog."
Herbert knows that if President Obama does not give him the waivers he wants from federal Medicaid requirements, he retains the option to just walk away. That would do great harm to thousands of Utahns who have no political clout, and make the governor a hero among those who have lots.
Even though the governor has said that it would be ‘"illogical" of the state to leave hundreds of millions of dollars of federal money on the table and be left with the burden of caring for poor Utah families without offered federal aid, he still has the feds over a barrel.
While Herbert’s plan is clearly superior to the less-than-nothing option proposed during the last legislative session by House Speaker Becky Lockhart, it retains an unnecessary air of condescension and disrespect to the most vulnerable of our friends and neighbors.
Rather than simply accept expansion of the federal-state Medicaid program to cover households with incomes of up to 138 percent of the federal poverty level — those now too affluent to be on Medicaid but too poor to qualify for federally subsidized health insurance policies — Herbert wants to do something different. Not better. Not more humane. Just different.
He wants the feds to block grant $258 million a year that would otherwise have gone for flat Medicaid expansion and use it to buy private insurance policies for those families, require that recipients make some kind of co-pays and add a work requirement. That is, launder the money through the very health insurance market that has made the American health care system the most unaffordable and unfair of any in the civilized world, while adding expensive and insulting layers of bureaucratic meddling in the lives of poor families.
The hell of it is, Herbert is likely to get what he wants. By letting the issue fester as long as he has — turning his back on, so far, more than $11 million in funds that could already have gone to alleviating the physical, emotional and financial suffering of up to 110,000 uninsured Utahns — he has shown that he will not be rushed nor cowed into an unwanted settlement just to help poor folks.
Obama probably will, and probably should, give Herbert what he wants. Because only by caving in to this blackmail will the president get poor Utahns the aid they need.
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