Commentary: Time to give Utahns what they want. Expand Medicaid.
(Francisco Kjolseth | Tribune file photo) A truck adorned with digital billboards and paid for by Utah Decides circles the Capitol complex during the second week of the session, showing support messages for Prop 3 with “Respect Voters” and other pro-initiative statements on Tuesday, Feb. 5, 2019.
It’s official. The Center for Medicaid Services (CMS), has rejected the Utah Legislature’s watered-down replacement of the full Medicaid expansion passed by the voters of this state last November. It’s now time for the Legislature to give Utahns what they voted for and proceed with full Medicaid expansion. No more delays. No more hoops.
People are literally dying, meanwhile, Utah taxpayer dollars – approximately $2.5 million a month – are being wasted because the Legislature has dragged its feet for entirely too long.
As a reminder: traditional Medicaid acts as a federal-state partnership with states paying 30 percent of the costs and the federal government picking up 70 percent. The Patient Protection and Affordable Care Act changed this to allow states that expand Medicaid to people earning up to 138% of the federal poverty level ($26,900 for a family of three), to participate with the federal government covering 90 percent and states paying 10 percent. SB96, which overrode the voters and repealed Proposition 3, requested that CMS grant waivers giving Utah a 90-10 rate, without fully expanding to 138 percent.
As we pointed out repeatedly during the SB96 debate, no state has ever been granted such waivers, nor should they. The entire point of the 90/10 rate was to encourage states to expand Medicaid so that these individuals who are unable to earn enough to afford insurance premiums can have access to quality health care and the security of knowing that their family doesn’t have to choose between paying an insurance premium and putting food on the table.
Gov. Gary Herbert has told the state Department of Health to move forward with submitting the Phase III or “fallback” waiver, even though we know the Trump Administration has all but rejected it, too.
When they rejected our second waiver, also known as Phase II, CMS specifically told us that they would not be granting waivers for a partial expansion or an expansion with enrollment caps. Why would our third waiver request be any different?
The Legislature has run out of excuses to keep Utahns waiting for the health care they need and are already paying for. In fact, because SB96 depended on unprecedented waivers, the state is now paying more to cover fewer people than expanding to 138% of the federal poverty level.
The Legislature can and should authorize the state to proceed with full Medicaid expansion up to 138% of the poverty level, as most Utahns voted for under Prop 3. Changing the statute now during a special session wouldn’t require much more than rewriting a small subsection of the law. We should act now.
Many of our colleagues worry Utah simply cannot afford it. But other Medicaid expansion states continue to see positive results, primarily improved coverage and access to care.
Additionally, growing evidence shows expansion states are experiencing numerous economic benefits, including state budget savings, revenue gains and overall economic growth. Multiple studies indicate that full Medicaid expansion helps offset other costs to the state, resulting in overall savings.
Other states that have expanded are also seeing reduced uncompensated care costs for hospitals and clinics, which lowers premiums for marketplace health plans.
This makes sense. A more favorable cost-sharing arrangement with Washington that covers more Utahns not only means more people having access to health care, it means more money into our state’s economy. Every dollar spent by these patients flows right back into our state’s economy.
Politicians sometimes like to make issues sound more complicated than they are so the public tunes out. Do not tune out. This one really is as simple as it seems. You voted for full Medicaid expansion because it is morally and fiscally responsible policy.
It is time for the legislature to respect the will of the people we were elected to serve. If we are truly representing the “Voice of the People,” we must proceed now with the Medicaid expansion Utahns want.
Signed, members of the Utah House and Senate Democratic Caucuses: Rep. Patrice Arent, Rep. Joel Briscoe, Rep. Jennifer Dailey-Provost, Rep. Susan Duckworth, Rep. Suzanne Harrison, Rep. Sandra Hollins, Rep. Karen Kwan, Rep. Brian King, Rep. Stephanie Pitcher, Rep. Marie Poulson, Rep. Angela Romero, Rep. Carol Spackman Moss, Rep. LaWanna “Lou” Shurtliff, Rep. Andrew Stoddard, Rep. Elizabeth Weight, Rep. Mark Wheatley, Sen. Gene Davis, Sen. Luz Escamilla, Sen. Jani Iwamoto, Sen. Derek Kitchen, Sen. Karen Mayne, Sen. Kathleen Riebe.