A chorus of residents stood up during a tense, two-hour public hearing to bemoan the complicated applications, stricter eligibility requirements and other restrictions Utah’s proposed Medicaid expansion would place on care for vulnerable patients.
"I need services, I need outpatient and inpatient, I need to have some options," Adam Montgomery, a resident who is being treated for bipolar disorder, told the crowd.
The Utah Department of Health met with residents Thursday to collect feedback before submitting the plan to the federal government.
Nathan Checketts, the director of the department's Medicaid program, estimated the waiver request would be submitted sometime this summer.
During the hearing, some health care advocates expressed concern that a scaled-back version of the voter-approved law would leave thousands of people without proper medical coverage. Advocate Stacy Stanford said the work requirement and enrollment cap outlined in the regulations would block people from receiving critical health care.
"If Medicaid was a pot of gold, the maze to get to it has just gotten more complicated," Stephanie Burdick, a community advocate who works with disabled people, said.
State officials said the requests are intended to reduce uncompensated care and prevent the Medicaid program from cutting into funds from Utah's general budget, among other goals.
Former President Obama expanded Medicaid coverage under the Affordable Care Act, often dubbed "Obamacare," allowing states to broaden eligibility and offer subsidies to help people buy health insurance. Many Republican-leaning states have refused to expand the program, citing financial constraints and ideological reasons.
Utah rolled out its partial Medicaid expansion in April, and plans to ask the federal government for a first-of-its-kind waiver to cover a larger share of the program. State officials also want to add a work or "community engagement requirement" for some individuals to receive health coverage. Lawmakers have gotten assurance from the Trump administration that the waivers would be approved, but the federal government hasn't commented.
More than 29,000 residents were enrolled in Medicaid as of June 4, according to the Utah Department of Health.
The proposal signed into law earlier this year would expand low-income health coverage to some residents who earn up to 100% of the poverty level — about $12,490 for an individual or $25,750 for a family of four.
Utah's partial expansion is expected to cover up to 90,000 people; the voter-approved law would have expanded coverage to some 150,000 people making less than about $17,200.
A second public hearing is scheduled for June 17, where advocates say they will continue to push for expanded health care.