Utah Lt. Gov. Spencer Cox says he doesn’t expect voter-approved Medicaid expansion to be delayed

(Francisco Kjolseth | Tribune file photo) Lt. Governor Spencer Cox announces plans by Shelter the Homeless to sell the downtown community shelter property to the State of Utah while gathered in front of the Rio Grande Depot on Tuesday, Sept. 25, 2018.

Utah lawmakers are considering legislation to delay and effectively repeal Utah’s Medicaid expansion initiative, but Lt. Gov. Spencer Cox said Wednesday that he expects the voter-approved plan to proceed.

Cox’s comments came during a meeting of the Pioneer Park Coalition and in response to an anonymous question about how halting Medicaid expansion could affect progress made with Utah’s homeless population during Operation Rio Grande.

“We don’t think there’s going to be a delay in implementation on Medicaid expansion,” Cox said. “The governor and I are moving forward as if it is going to be implemented under the original timeline, as expected.”

Cox said the outcome of Medicaid legislation would likely not have a direct impact on Operation Rio Grande, as the homeless population was already included in a targeted expansion of Medicaid approved by lawmakers in 2016.

While he expects the expansion to proceed — Proposition 3 received 53 percent of a statewide vote in November — Cox said steps may need to be taken to protect the longer-term sustainability of the program.

“It’s very clear that tax increase [in Prop 3] is not going to cover the entire amount of the expansion,” he said.

Under Proposition 3 — which is set to take effect in April — a state sales tax increase will generate roughly $90 million, which will be combined with $800 million in federal funding to provide health care to 150,000 low-income Utahns, including those earning up to 138 percent of the federal poverty level.

Supporters of the initiative say the funding structure is sufficient to pay for expansion, and that unforeseen costs in the future could be dealt with through budget prioritization.

But Republican state lawmakers have long opposed full expansion, citing the increased cost to the state. And despite the majority vote in favor of Prop 3, Sen. Allen Christensen, R-North Ogden, is preparing legislation to impose enrollment caps and work requirements on beneficiaries, and to delay implementation of the expansion until those changes can be approved by federal Medicaid administrators.

Christensen’s changes would incorporate the sales tax increase portion of the Medicaid initiative, while reinstating much of a previous partial-expansion plan approved by lawmakers last March that failed to secure a federal waiver before the November vote on Proposition 3. That program would have covered an estimated 70,000 low-income Utahns.

“We are going to implement Medicaid expansion. We are going to implement the sales tax increase to help pay for it,” Christensen told The Tribune last week. “But we have to put some bumpers or guardrails around it so that it isn’t going to break the bank.”

Asked to elaborate on his comments to the Pioneer Park Coalition, Cox said he had not yet seen the specifics of Christensen’s proposal. But he added that there is a concern that future costs of Medicaid expansion could lead to cuts to education and other government programs.

“The governor proposed Healthy Utah, which [was] very similar to expansion with a couple caveats that are important to make sure that we stay within budget,” Cox said.