Utah Limits Voter-Approved Medicaid Expansion

By: - February 12, 2019 12:00 am

A counter-protester, right, supports Utah lawmakers’ plan to scale back a voter-approved Medicaid expansion to control costs. Republican Gov. Gary Herbert signed the measure into law. Lindsay Whitehurst/The Associated Press

In apparent defiance of the will of Utah voters, Republican Gov. Gary Herbert signed into law a limited and initially more costly Medicaid expansion measure than the referendum approved in November. The new measure also would require federal approvals.

Herbert defended the measure, which he said in the long run will be more economically sound for the state.

And, taking on critics, he denied that he was rebuffing the will of the voters, who passed the Medicaid expansion initiative with 53 percent of the vote.

“I see this as a thoughtful effort to implement the will of the people to care for the poor with quality health care with the added benefit that it can be sustained over the long term with no reduction in other important social services,” Herbert said, according to the Salt Lake Tribune.

The ballot initiative proposal would have extended Medicaid benefits to Utah residents with incomes up to 138 percent of the federal poverty line. The measure signed by the governor, meanwhile, would provide benefits only to those making up to 100 percent of the poverty line.

Senators voted 22-7 to adopt the House version of the bill, sending it on to the governor.

Jonathan Schleifer, executive director of The Fairness Project, a group pushing affordable health care for all, lambasted the bill before the governor signed it.

“The legislature is trampling on the clear will of voters, and it’s stripping tens of thousands of Utahns of access to care in the process. It seems many members have forgotten they’re supposed to work for the people of Utah — not special interests or extreme ideologues,” Schleifer said, according to Politico.

Full Medicaid expansion, in keeping with the provisions of the Affordable Care Act, would have increased federal reimbursement to the new class of Medicaid beneficiaries to 90 percent. Herbert and Republicans in the legislature say they are confident that they will win approval from the Trump administration for the same level of federal support even though the measure doesn’t adhere to the ACA, also known as Obamacare. Currently, the federal government pays 70 percent of the costs of Medicaid beneficiaries in Utah with the state paying the rest.

According to estimates, the initiative would have added about 150,000 people to Medicaid. That number has now been reduced by about 48,000.

An analysis by the Utah fiscal office found the state would initially spend more money to cover fewer people because lawmakers’ scaled-back version doesn’t qualify for increased federal money.

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Michael Ollove

Michael Ollove covers health care for Stateline. Ollove worked for many years at The Baltimore Sun, as an enterprise reporter and an editor.