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Expanding for children » Today Medicaid covers about 279,000 Utahns and costs $2.2 billion, two-thirds of which comes from Uncle Sam.
Herbert’s ‘Healthy Utah’ proposal
Participants in the “Healthy Utah” plan envisioned by Gov. Gary Herbert would have to contribute an average of $420 a year toward their health care.
Some would face a work requirement. Low-income parents whose children are on Medicaid could get financial help to move the whole family onto a private health plan.
“On private insurance they can probably get better quality of care and will have more insurance choices to fit their unique [health] needs,” Herbert said. “Nobody’s getting a free ride; they’ve got to put skin in the game. It’ll make for a better program with better outcomes and give us better bang for the buck.”
"All the federal programs would push our budget out of whack. That’s been a perennial problem," said Norm Bangerter, who served in the Legislature in the mid-1970s and was Utah’s governor from 1985 to 1993.
"We always seemed to manage," Bangerter said, but as health costs soar and Medicaid demands a greater share of tax revenue, "it gets harder and harder."
Through the years, Utah’s eligibility rules changed and enrollment fluctuated, but it generally grew in pace with the population. Some states have threatened to drop Medicaid — which has never happened — while others have expanded eligibility.
The biggest expansion came in 1997 with creation of the Children’s Health Insurance Program (CHIP).
The economy was booming and President Bill Clinton’s push for comprehensive health reform had failed. CHIP, seen as a concession, had bipartisan support, sponsored by Utah Republican Sen. Orrin Hatch and Massachusetts Democratic Sen. Ted Kennedy.
Hatch told The New York Times he was offering the legislation to prove that the Republican Party "does not hate children."
As a nation, he added, "we have a moral responsibility’’ to provide coverage for the most vulnerable children.
He was attacked, however, by conservatives in Washington and Utah. The Eagle Forum branded him a "Latter Day Liberal."
Utah lawmakers "protested strongly against taking federal money for another entitlement program, and it wasn’t certain how many children would qualify," recalls Rod Betit, who directed Utah’s Health Department under then-Gov. Mike Leavitt.
The duo lobbied Congress to shoulder more of the funding burden, and to permit states to cap enrollment and model CHIP benefits on private insurance plans.
"Hatch and Leavitt were arm-wrestling over it because Kennedy didn’t want to make concessions. But we were able to get the governors to push the issue [of flexibility]," said Betit. "That was the only way the thing got through the [Utah] Legislature. It passed by just a few votes [in 1998]."
‘Spend it in a better way’ » Today, Herbert is seeking flexibility from Washington to create a program lawmakers can support.
"He wants to bring some fiscal certainty to it and tie it to the private market," Betit said. "Those same kinds of dynamics are happening again."
Herbert wants the Obama administration to hand over Utah’s share of federal expansion funds — about $258 million a year — to fund private coverage for 111,000 poor and uninsured.
The feds are offering to pay the full costs of added Medicaid beneficiaries for the first three years and no less than 90 percent thereafter.
A growing federal deficit heightens fears that may change. This winter, Utah House Speaker Becky Lockhart, R-Provo, rejected the idea of taking the new Medicaid funds, arguing, "It would be irresponsible for the state of Utah to perpetuate reliance on federal money and continuance and reinforcement of a socialized medical system."
Congress has never withdrawn or reduced Medicaid funding, and increased it to help states through recessions in 2002 and 2004.
And the Congressional Budget Office has determined, more than once, that the Affordable Care Act (ACA) will reduce the deficit, and that repealing it would increase the deficit. That’s because of a host of new taxes, predominantly on the health industry.Next Page >
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