A small band of conservative volunteers is mounting the only organized fight against expanding Medicaid and raising the gas tax to fund education in Utah

(Trent Nelson | The Salt Lake Tribune) John Morris, a volunteer with Americans For Prosperity, calls voters to oppose Question 1, a ballot item polling voters on support for a gas tax increase, Wednesday Sept. 19, 2018.

Lehi • John Morris made it only a few seconds into a phone call on Wednesday before he was cut off.

“I’m not asking for money,” Morris said, attempting to keep the conversation going.

It was too late — the person on the other end had hung up, so Morris moved to the next number on his list.

The call was one of countless that Morris has made as a volunteer for the Utah chapter of Americans for Prosperity (AFP). On more successful attempts, he launches into a well-rehearsed 30-second pitch about two tax increase proposals on the November ballot, and why Utah voters should reject them both.

“An uneducated population is a danger to themselves,” Morris said of the time commitment. “The more educated a population is, the less it can be taken advantage of by our Legislature and those in charge. That’s why these calls are so important.”

(Trent Nelson | The Salt Lake Tribune) Jessie Morris and Sam Fisher, volunteers with Americans for Prosperity, call voters to oppose Question 1, a ballot item polling voters on support for a gas tax increase, Wednesday Sept. 19, 2018.

Americans for Prosperity is a nonprofit advocacy group founded by billionaire conservative David Koch. A force behind the tea party movement, the group pushes lower taxes and limited government.

Once a week, a group of roughly a dozen volunteers gathers at AFP-Utah, which is currently housed rent-free in an office building in Lehi where renovation is ongoing. Some sit, while others amble through the spartan space decorated with posters of Ayn Rand and banners pitching such catchphrases as “Wiser spending not more taxes” and “More money doesn’t create better outcomes.”

A second, smaller, group also meets weekly at a pizza restaurant in Layton.

They collectively make thousands of calls over the course of a few hours, running through a script that warns of runaway costs and increased federal control if voters fully expand Medicaid through Proposition 3, or criticizes wasteful spending as a way of deflating Question 1, a nonbinding proposal to fund schools through a higher state gasoline tax.

Utah had a $650 million surplus this year, grass-roots director Joni Beals tells a voter named Daniel, more than what proponents of Question 1 hope to raise through a 10-cent-per-gallon tax hike. She argues state lawmakers should have prioritized more of that surplus for education instead of pushing the ballot question.

Beals, who joined AFP as a volunteer in 2015, said the calls are focused on Utahns who appear to be persuadable on the issue based on voter data. As the election gets closer, she said, the operation will shift to voters who are expected to already oppose a tax increase in order to get out the vote.

(Trent Nelson | The Salt Lake Tribune) Elizabeth Crofts and Joni Beals, volunteers with Americans for Prosperity, call voters to oppose Question 1, a ballot item polling voters on support for a gas tax increase, Wednesday Sept. 19, 2018.

With six weeks to go before Election Day, Americans for Prosperity is effectively alone in mounting a campaign against Question 1 and Proposition 3.

Other right-leaning groups have criticized the initiatives, and a formal statement of opposition to Medicaid expansion signed by 39 Utah lawmakers is included in the state’s official voter guide. But the fight pales in comparison to the one surrounding Proposition 2, a medical marijuana proposal facing a broad coalition of opponents — that includes The Church of Jesus Christ of Latter-day Saints. The opponents have held news conferences, purchased advertisements and issued calls for a special legislative session to derail the legalization initiative.

“Prop 2 has really taken center stage with everybody,” said Heather Williamson, state chapter director of Americans for Prosperity.

The perceived quiet surrounding Question 1 can be partly explained by its origins. Facing an initiative to hike sales and income taxes by the group Our Schools Now, lawmakers agreed to cut a deal.

The Legislature boosted school spending through a combination of property and income tax adjustments, while agreeing to place the question of a gas tax hike on the ballot in November to gauge the will of the public on further school and road investment.

“Voters are learning Question 1 would cost just $4 per month and invest directly into the classroom — not [school] administration,” said Our Schools Now spokesman Austin Cox. “We must invest in Utah teachers to put Utah kids first.”

But on Proposition 3, the relative silence on the issue of Medicaid expansion follows years of vocal opposition by Utah legislative leaders. Multiple attempts at expanding Medicaid have stalled over the years amid concerns of runaway spending, leading to the push for a limited expansion plan.

This year, legislation was passed that could increase Medicaid coverage under a scheme that requires a waiver from the federal government and which was largely was seen as a scaled-down response to Proposition 3.

“We already have a responsible, compassionate Utah solution to care for our most vulnerable,” the voter guide’s opposition letter, written by Rep. Robert Spendlove, R-Sandy, states. “This initiative goes too far.”

Greg Hartley, chief of staff to House Speaker Greg Hughes, R-Draper, said the lawmakers who rejected full expansion remain opposed. But, he added, during an election year they have their own re-elections to focus on rather than running campaigns against ballot initiatives.

“I found out last night that AFP and others are fighting it,” Hartley said. “To date, we haven’t heard of any organized effort.”

Morris had his own take on the dearth of legislative voices opposing Proposition 3. He suggested that lawmakers didn’t want to initiate the expansion but are happy to receive the sales tax and federal revenue if the initiative succeeds.

“They want to see it,” Morris said, “but they don’t want it on their shoulders.”

If approved, Proposition 3 would raise sales taxes by 0.15 percent, or less than 2 cents on a $10 purchase. The increase would raise $90 million, which would be combined with $800 million in federal funding designated for the state, to provide medical coverage to 150,000 low-income Utahns.

RyLee Curtis, campaign director for Proposition 3, said the sales tax was intentionally calculated to exceed costs, providing sustainable funding for the immediate future.

“Like with any government program,” Curtis said, “we will always have to be evaluating the cost as years go on.”

Anna Dick said she had never heard of Americans for Prosperity until Tuesday. On Wednesday, she was at the Lehi office volunteering to make calls.

She has worked in emergency room billing in California and Utah and said she has seen firsthand how expansion of Medicaid denies health care to the people who really need it.

More people on Medicaid means more crowded hospitals and waitlists, she said. And the delay for preventive care leads people to the emergency room for nonemergency situations.

“It just creates a giant mess,” she said. “The ER can’t turn people away, so you’re going to end up with that problem.”

She said most voters don’t understand the issue. They’re motivated by compassion, she said, but don’t realize how trying to cover everyone leads to less efficient and less effective care.

“Most people have the best intentions; they just want to help,” Dick said. “They want people to be able to have coverage. They just don’t understand that comes at a cost, and that cost is going to hurt the people who ultimately do need it.”

Curtis, who supports Prop 3, had a 180-degree different view than Dick. She said lack of coverage leads to crowded emergency rooms as patients are unable to see a primary care physician. By expanding Medicaid, Curtis said, patients are able to get health care through more efficient and appropriate channels.

“We haven’t seen any states retract their expansion of Medicaid,” she said. “In fact, we’ve seen the opposite.”

Amelia Powers, an AFP volunteer and Republican nominee for Utah County clerk-auditor, said she lived in Canada for four years but moved back to the United States because of the inability to get decent health care in a timely manner under Canada’s system.

When she was 15 weeks pregnant with her second son, Powers said, she contracted E. coli. Her doctor wanted her in the hospital, but she wasn’t admitted for hours as her condition worsened, leading to months of bed rest and fears she would lose the baby.

“Because people don’t have to pay for that medical care,” Powers said, “they just go to the hospital for anything.”

As a child, she said, her family received government assistance, and after moving back to the United States, she lacked health insurance for a time. But the medical community is not an “evil empire," Powers said, and options exist for people who lack coverage.

“You can go get a job that has health insurance,” Powers said. “Or I paid cash. I went in, and I paid cash.”

Curtis said that years of polling show that Utahns understand and are supportive of Medicaid expansion. By not doing so, she said, the state has forfeited hundreds of millions of dollars in annual funding that its residents pay to the federal government.

“It’s either use it or lose it,” Curtis said. “And right now, we’ve been losing it.”

But while most of the expansion is funded with federal dollars, there is still the local pinch of a 0.15 percent sales tax increase. And Williamson, the chapter director of AFP, said Utahns have faced a series of tax increases in recent years, at all levels.

It’s a huge concern for many Utahns, she said, as they are asked to pay while government seeks ever-increasing revenue to support its spending habits.

“We’re seeing government spending increase and taxes increase,” she said. “We’re seeing cost-of-living increases, we’re seeing the housing prices out of control skyrocketing. What we’re not seeing is individuals' paychecks going up — they’re staying the same.”