Trib Caucus: During week two of the legislative session, lawmakers consider a Medicaid replacer bill, changes to the state constitution

Every week during Utah’s legislative session, The Salt Lake Tribune’s political reporters and columnists chat about the hottest topics of the week. The following is a lightly edited transcript of their conversation.

Taylor Stevens (government reporter): Welcome to this week’s Trib Caucus Slack chat, which will be convening weekly during the 2019 legislative session. We’re 10 days in (out of 45) and already the Senate has approved a rewrite of a Medicaid expansion plan and state lawmakers have passed a bare-bones budget to keep the government going.

Let’s start with what’s arguably been the biggest story of the session so far: Medicaid. What happened this week and where are we going?

Benjamin Wood (government reporter): Republicans are committed to not enacting Prop 3. So their vehicle in that effort, SB96, has passed the Senate and House committee and will likely pass the House Friday.

[Editors note: The Utah House voted 59-16 in favor of SB96 on Friday]

Stevens: @bwood it was surprising to see the bill sponsor, Rep. Jim Dunnigan, vote against the Medicaid replacer bill in committee. What happened there?

Wood: Good question. I tried asking and he refused to answer. Prompting a good old-fashioned media chase down the halls of the Capitol.

Best we can tell, there’s a lot of concern around SB96 because it’s risky. If the feds don’t sign off on the state’s plan then Utah would quickly run out of money to cover anyone on Medicaid.

Robert Gehrke (political columnist): If I could speculate a little, Dunnigan’s district (I believe) voted for the expansion. And I think it was a way for him to signal that Christensen’s bill, even without the automatic repeal if the state didn’t get the Medicaid waivers, was not the final version — which is what we saw today with the new substitute that would essentially enact most of Prop 3 if the state doesn’t get the waivers from the Trump administration.

Wood: The signaling makes sense. And the new version of the bill is a pretty dramatic change from the one in committee. Instead of auto-repealing if the feds say “no,” the new version would, in essence, let Prop 3 go forward.

Gehrke: It incorporates Rep. Ray Ward’s bill essentially, expanding Prop 3 fully if the waivers are rejected.

Wood: Everyone is being hush-hush about it, but it’s sounding like that may be the secret sauce to get this thing a 2/3 vote in the House.

Gehrke: It puts advocates in an interesting position. Because if they really believe the Trump administration won’t approve the waivers — as they have been arguing — then this bill will eventually give them the full expansion they wanted (eventually being kind of key).

Wood: Those waivers are a minefield. We’ve reported how no other state has what Utah would be asking for and there’s a reason for that. Obamacare is a federal law and the waiver lawmakers would be requesting would fundamentally reshape Obamacare. That is all-but-certain to be challenged in federal courts, which means delays while it’s adjudicated.

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Gehrke: And House leadership is saying they’re so sure they’ll get the waivers, it doesn’t matter what the fallback is. They don’t need a Plan B. This is, essentially, a way to comfort jittery House members (like Reps. Mike Winder and Craig Hall, whose districts backed Prop 3 and who also voted against this in the committee).

I think some of the waivers are easy. The hard one is getting the feds to pay 90 cents of every Medicaid dollar spent in the state, but not covering up to the 138 percent level. As Ben mentioned, no other state has been given that.

Wood: That’s the big fish. They’re confident they’ll get it, but everyone outside of the Utah Legislature is much less confident.

Bethany Rodgers (political reporter): Does the latest version of the bill resolve the estimated funding shortfall if the waivers are denied and the Prop 3 expansion goes into effect?

Wood: It does. Like @gehrke said, the new fall-back is essentially Rep. Wards HB210, which tweaks the funding enough to run a surplus instead of a deficit.

Plus, they’d still be going after work requirements even with the fallback to full expansion, because Republicans philosophically object to giving poor people free things.

Gehrke: The latest version also includes the hospital tax, it looks like, something Ward’s bill did not.

Stevens: It seems like there’s some anger out there among Utahns who feel like their voices have been ignored yet again through this replacer bill. Do you think this could have impacts come next election, @gehrke, or are voters’ memories not long enough?

Wood: If I were a GOP rep in a district that passed Prop 3, I would be very nervous about this vote.

Gehrke: Legislative fiscal analysts say Ward’s bill (HB210) would build up a $195 million surplus that would go in a trust fund over the next several years — without collecting $15 million a year in hospital taxes. So it looks like it should be on firm financial footing. Really it’s the most financially solid plan on the table.

I think MOST of the legislators don't have to worry about this. But there are definitely some who do, primarily in Salt Lake County.

Again, Reps. Hall, Dunnigan, Winder, Eric Hutchings, Steve Eliason ... those guys are in districts that supported Prop 3, and it could pose a real problem for them.

Wood: I talked to a Democratic lawmaker yesterday who said the GOP is doing the Dems’ opposition work for them. This makes for an easy mailer when you can list how the district voted on Prop 2, Prop 3 and Prop 4 and how a GOP rep rejected those results.

I agree with @gehrke. Outside of Salt Lake County, there’s no problem, but there are some Salt Lake County Republicans in relatively competitive districts.

Gehrke: The interesting thing that hasn’t got much attention is that rural Utah stands to benefit the most from expansion — more people outside of the Wasatch Front qualify for Medicaid, and rural hospitals in other states that struggle to stay afloat have also benefited when Medicaid has expanded.

Stevens: Let’s pivot.

We have a historic number of women in the Legislature this year with a high of 25, or 24 percent of Utah’s 104 lawmakers. This week, past and present representation in the Senate in particular took center stage.

@BethanyRodgers, what can you tell us about those conversations and how they got started?

Rodgers: It mostly played out over social media (no surprise there). But Sen. Deidre Henderson tweeted out a list of female state senators in Utah over the last 120-plus years, and the names fit comfortably on one page. A local historian had compiled the rundown for her and, while the initial version contained a few errors, we later determined that the total number of women senators in Utah since 1897 has been *drumroll* ... 29.

Wood: Most of whom were Democrats, yes?

Rodgers: Yes, the final breakdown was nine Republicans and 20 Democrats

Stevens: That’s barely enough to fill the Senate, as Lt. Gov. Spencer Cox pointed out on Twitter.

Rodgers: Exactly equal to the number of seats in the Senate, as a matter of fact.


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Gehrke: It was striking (and more than a little ironic) that when Utah was debating whether to put Martha Hughes Cannon’s statue in the U.S. Capitol that it was a debate almost entirely among men. (Cannon, of course, was a doctor and the first woman elected to the Utah Legislature, beating her husband for the seat.)

Stevens: In somewhat related news, there’s a bill this session looking at the gender terminology in Utah’s state constitution. @bwood, what would it do?

Wood: That’s right, Sen. Deidre Henderson is proposing to make the state constitution gender neutral.

There’s a few sections that defer to male language (his, him, himself) and it would swap those out for things like “spouse," ”the accused" and “him or her.”

Gehrke: It’s a little like when people put their preferred pronouns at the end of their emails.

Stevens: Doesn’t a change to the state constitution need to go before voters?

Wood: It would. Needs 2/3 in the House and Senate and then a majority vote of the public. Same process as what we just did with the amendment letting legislators call themselves into session whenever they feel like it.

Gehrke: This is something that legislators have been cleaning up over the years in statute. But changing the constitution would, as Ben notes, take approval by voters.

Stevens: Speaking of the state constitution, @BethanyRodgers, can you tell us about a bill from Rep. Sandra Hollins that’s looking at a change to the 13th Amendment?

Rodgers: Sure, that’s a bill to remove an exemption to the general slavery prohibition. The one time slavery is allowable, according to the constitution, is as a punishment for a crime. And Rep. Hollins says it’s high time to take this loophole out.

It's actually not language unique to Utah — it's drawn from the U.S. Constitution, and several other state constitutions have identical provisions.

Colorado just recently stripped the exemption from their state constitution, as a matter of fact.

Gehrke: It’s an interesting relic, isn’t it? I mean, even our prison inmates who make furniture, for example, get paid for it, as I understand. So it’s not been something that has been applicable for a long, long time, right?

Wood: This is one of those historically meaningful but procedurally symbolic moves. The courts have already ruled against slavery as a punishment, but like many things that have been struck down it takes time and effort to delete them from code.

Rodgers: That’s true, @bwood, but I think it does have some present-day implications to people who feel the criminal justice system perpetuates the systemic oppression that started with slavery.

Wood: No doubt, and that’s why I say historically meaningful. There’s similar concern about how the state constitution continues to prohibit same-sex marriage, despite the Supreme Court of the United States overturning those types of bans.

Stevens: Alright, that’s about all we have time for today. But before we go, let’s each make a prediction for what we’ll see in the session in the coming week.

Wood: I predict that SB96 will be signed by the governor before Wednesday.

Rodgers: I predict that we’ll see a tax reform bill dropped next week.

Gehrke: Once Medicaid is done and sent to the governor (probably by Monday) we’ll see a pivot to focus on tax issues. And it sounds like the governor’s grand vision for expanding the sales tax to apply to services is already falling apart.

Not surprisingly, the folks who provide those services who aren’t taxed now would like to continue to not be taxed. And it turns out they have very powerful lobbies on the Hill. So I agree with Bethany, we will see some progress on the tax reform (perhaps not a bill until the following week), but it will mostly just focus on tax cuts, largely out of the income tax. Not a real holistic rewrite of state tax law.

Wood: @tstevens will we get a hearing on hate crimes?

Stevens: That was going to be my prediction. I don’t think we’ll see a hate crimes hearing in committee next week. Sen. Daniel Thatcher, the bill’s sponsor, says legislators want some tweaks and it seems those are going to take a bit more time to hash out.

Wood: Interesting. We’re rapidly approaching the mid-session bottleneck.

Stevens: Indeed. See you all next week!

Readers, what’s your take on the debate over Medicaid expansion? And what do you think of the moves to update the state constitution? Let us know in the comments.

Have questions for the Trib Caucus? Email them to tstevens@sltrib.com or tweet @TribCaucus with the hashtag #TribCaucus for possible inclusion in a future chat.