Utah has arrived at a major point of decision regarding the expansion of Medicaid that I see as basically accepting a federal bribe only to be snared in a trap. In the discussion, some misleading information is being thrown around by otherwise well intentioned folks.
One example was published in the Tribune ("Healthy Utah plan good for Utahns and Utah business," June 27). In the piece, Mark Miller said 111,000 Utahns are without insurance, and thus we need to expand Medicaid eligibility to 138 percent of the Federal Poverty Level (FPL). That’s misleading. Utahns who fall between 100 and 138 of the FPL already have options. They are eligible for free or almost-free insurance through the State Exchange. The real uninsured pool - and the people on whom we should be focused - are those that live between 0 and 100 percent of FPL who are not currently enrolled in Medicaid. In 2016 that number will be 61,900.
As senate chair of the Health Reform Task Force and the Social Services Appropriations Committee, I have learned by experience to question every handout the feds offer. The strings attached would often put a puppet show to shame. It is important for people to understand the spin that proponents put on the Healthy Utah plan.
We’ve been told that Healthy Utah is not Medicaid expansion. That is untrue. Healthy Utah would put an additional 50,000 to 120,000 more Utahns on public support. That number will grow as employers find it is less expensive to drop their employee health insurance, pay the penalty, and shift their costs onto Healthy Utah (Medicaid). This is occurring in several states that have jumped on the ‘free money’ bandwagon.
Healthy Utah proponents want to call the federal money a block grant. Block grants are money received with minimal controls attached. The Healthy Utah plan does not resemble a block grant, but it is a catchy phrase.
Healthy Utah is called a three-year pilot. When was the last time we saw government end an entitlement program? It just doesn’t happen.
We are told that everyone else is expanding and we should not be left out. In fact, nearly half of the states — arguably the more fiscally responsible states — have opted for no expansion. Projections show that expansion will cost Utah taxpayers billions.
What about children in need, pregnant women, the elderly, or the disabled? The simple answer is that almost all are already covered by Medicaid. Many would actually be worse off if we add tens of thousands of more patients into an already crowded medical system with no additional doctors.
Spending at the federal level is out of control. Yet, any attempt to cut spending is met with wailing, finger pointing, and demands that the cuts be made elsewhere. Medicaid expansion is not even a spending cut. It would be a huge spending increase! So, why the clamor in our very conservative state to accept more federal money and control when we ought be screaming "Hell no"? Answer: Those who stand to gain by accepting federal dollars, borrowed from our grandchildren, have orchestrated a media campaign to convince us that we can’t pass up this "free" money.
Is there an alternative? Yes. Last year our community health centers together with numerous clinics and providers all across Utah delivered health care to hundreds of thousands of patients for free or at sliding scale cost. With a fraction of the dollars that expansion would cost and without a rigid, clumsy federal partner we can expand this system of care. We can preserve the dignity of our citizens, the giving nature of our health providers, and shout to the rest of the world that Utah is still the leader in giving while remaining financially prudent. We can better control our own destiny and do it the Utah way!
Allen Christensen is a Utah state senator representing parts of Weber, Morgan and Summit counties.
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