In November, after many years of efforts, the people of Utah were able to pass Proposition 3, which expanded Medicaid. The Legislature has been reluctant to support health care expansion despite many arguments that the expansion is needed to partially address the drug and alcohol addiction treatment that is part of Operation Rio Grande.
Operation Rio Grande is the effort to stop what had been described as the largest open-air drug market in the Western United States. The effort relies on increased public safety efforts, addiction treatment and supporting employment. The latest figures from Operation Rio Grande provide a very powerful argument to not change Proposition 3 implementation.
By the end of 2018, according to Lt. Gov. Spencer Cox, more than 3,000 adults have enrolled in Medicaid. Almost 1,500 have accessed treatment services in Salt Lake County. But the third phase of Operation Rio Grande statistics show that only 152 were employed by the end of 2018!
If 3,000 are enrolled in the Legislature’s plan that was approved at the end of 2017 (after a year of trying to persuade the federal government to agree to a minimal health care expansion for the chronically homeless for more than 12 months), and only 152 are employed, then a work requirement is useless.
The Legislature also has been attempting, until Proposition 3 passed, to expand Medicaid for mental health treatment. It is a recognition that much of the substance abuse is due to underlying mental health issues. Former Sheriff Jim Winder kept saying that more than 80 percent of the incarcerated individuals in his jail had mental health issues and symptoms that often were substance-abuse related. The federal government has refused for more than a year to approve the Legislature’s mental health plan. Adding to the problem, mental health services in Utah were significantly cut back due to the recession of 2008.
Proposition 3, when fully implemented, does not just expand Medicaid and health care for those making up to 138 percent of the poverty rate, it also provides increased mental health treatment that is sorely lacking in the substance abuse treatment efforts. Cox, in a recent talk to the Pioneer Park Coalition, said the Proposition 3 sales tax increase did not appear to fully fund the Medicaid expansion. That questionable claim appears to be the reason for trying to repeal and replace Proposition 3 and add a work requirement.
If one reasons it out, adding a work requirement for individuals who need mental health care will result in most of those potentially treatable individuals walking away and continuing to treat their issues with the illegal drugs that are available.
The other argument that should persuade the Legislature to not touch Proposition 3 implementation is the obvious appearance that criminals are getting better health care than low-income workers. If someone is making 138 percent of the poverty rate (and arguably still in poverty), they are working! Adding a work requirement and decreasing health care expansion to those making up to 100 percent of the poverty rate is an insult to the 50,000 low-income Utah workers (who make between 100 percent and 138 percent of the poverty rate) who are working and trying to follow the law.
There are many reasons that the Legislature should allow Proposition 3 to be fully implemented. Starting a modified plan may not be fully reimbursed by the federal government and will risk Utah taxpayer money. The work requirement does not appear realistic according to the statistics from Operation Rio Grande. Again, 3,000 accessed treatment and 152 are working.
Real success in fighting drug abuse requires increased mental health treatment, which does not happen with a work requirement.
Public safety is significantly increased with better mental health treatment. This should be a public safety no-brainer. Proposition 3 should be implemented without any change.
George Chapman is a former candidate for mayor of Salt Lake City and writes a blog at georgechapman.net.