Can state leaders, Herbert compromise on Medicaid before session?

February 14, 2015
Author: Lisa Riley Roche

SALT LAKE CITY — Legislative leaders and Gov. Gary Herbert are still split over his Healthy Utah alternative to Medicaid expansion, but there's a chance an agreement can be reached before the 2015 Legislature begins meeting Jan. 26.

"Next week we are locking ourselves in a room and seeing if we can't come to some sort of idea, compromise agreement," Lt. Gov. Spencer Cox said Wednesday at the United Way's annual legislative preview breakfast.

Cox said he and Utah Health Department Executive Director David Patton will hash out what's best for both taxpayers and Utahns without health insurance with several lawmakers, including House Majority Leader-elect Jim Dunnigan, R-Taylorsville.

Later, Dunnigan said he and Cox are going into the Jan. 21 meeting with "a desire for an outcome to advance the ball and do something." Dunnigan participated in the governor's negotiations with the Obama administration about Healthy Utah.

Herbert's plan would use the nearly $300 million available to the state for Medicaid expansion under the Affordable Care Act to help provide private insurance to low-income Utahns, including those who otherwise would not qualify for subsidies from President Barack Obama's signature health reform law.

The Healthy Utah plan, now the subject of renewed negotiations with the Obama administration over whether participants would be required to work, is a top legislative priority for the United Way.

But GOP lawmakers have balked at making what they see as a long-term commitment to providing coverage, citing concerns over the federal government's ability to fund the program and questions over how many Utahns would use it.

The Legislature's Health Reform Task Force, headed by Dunnigan, rejected Healthy Utah last month and endorsed extending Medicaid expansion benefits only to the medically frail.

"We think this is a one-time shot. So it's one that everybody takes very seriously," House Speaker-elect Greg Hughes, R-Draper, said at the breakfast, noting House Republicans have resolved to "do something" this session, but it must be sustainable.

"The state's got to keep its promises. If it's going to say we're going to cover people right now that are not covered, you can't say it this year and you can't say it in the best of times and simply pull it back when times are harder," Hughes said.

Senate Majority Leader Ralph Okerlund, R-Monroe, told the audience of community, business and political leaders that Senate Republicans also want to take action on Medicaid expansion this session but have yet to decide what that will be.

"The middle ground is no longer an option," Okerlund said.

The choice for Senate Republicans, he said, is either going along with the task force recommendation to limit coverage to the medically frail or back Healthy Utah.

Republicans hold veto-proof supermajorities in both the House and Senate and so may well have the last word on the GOP governor's plan. Democrats have supported accepting the available expansion of Medicaid.

House Minority Leader-elect Brian King, D-Salt Lake, said at the breakfast that Healthy Utah is a "pullback" from Medicaid expansion, but is better than the task force recommendations.

King said those recommendations turn Utah's status as one of the nation's best-managed and most fiscally responsible states into a joke and questioned why there would be any hesitancy to accept all of the federal dollars available.

Both King and Senate Minority Leader Gene Davis, D-Salt Lake, pointed out that former House Speaker Becky Lockhart, who is suffering from an extremely serious but undisclosed illness, has health insurance.

"She's got access to health care, thank heavens," King said. "What if she didn't? Wouldn't that be a heartbreaking circumstance that someone as critically ill as she is at this point didn't have access to the kind of health care that most of the people in this room take for granted?"

Davis asked what would happen to Lockhart and her family "if they did not have the income or the access to health care. That's what this is all about. Medicaid expansion is not about giving some great service to people. It's about giving them access, affordable access, to health care."

In his opening remarks, Cox advised the audience they should all be praying for Lockhart. He said her "very difficult medical issues" should be a reminder of what is truly important.

"I hope it helps us remember what it is we’re really doing here and what really matters," the lieutenant governor said. How people treat each other, he said, "matters far more than anything we will ever do in state government."