Governor Gary Herbert wants Medicaid expansion in place by January

By Whitney Evans, Deseret News

Published: Fri, June 13, 2014, 7:25 p.m. MDT

 After meeting with new Health and Human Services Secretary Sylvia Burwell on Friday, Gov. Gary Herbert said he is confident that he will have a plan ready for legislators by the end of the summer or beginning of fall, with expansion by early 2015.

After meeting with new Health and Human Services Secretary Sylvia Burwell on Friday, Gov. Gary Herbert said he is confident that he will have a plan ready for legislators by the end of the summer or beginning of fall, with expansion by early 2015.

(Rick Bowmer, Associated Press)

SALT LAKE CITY — Utah's governor said Friday he hopes to hand Utah legislators an alternative Medicaid expansion plan by fall and have the state's expansion in place by January.

Gov. Gary Herbert's comments came after meeting with new Secretary of Health and Human Services Sylvia Burwell, whom he said was informed and supportive of his Healthy Utah alternative to President Barack Obama's Medicaid expansion plan.

She has "a new set of eyes and ears and a desire to get something accomplished," he said, noting a few hurdles are left to clear before the federal government signs off on the plan to bring more coverage to Utahns. That includes a requirement for recipients to work or be looking for work to qualify, Herbert said.

"We think it's a principle that the recipients ought to have some skin in the game proportionate to their ability to pay," Herbert said, comparing the work provision to the state's food stamp program, Temporary Assistance for Needy Families and Supplemental Nutrition Assistance Program.

"We have models out there that work. We just need to see if they can be incorporated into the Affordable Care Act and this Medicaid expansion alternative."

He said he hopes to have approval for that in 30 days.

Medicaid expansion is part of Obama's Affordable Care Act that went into effect in January. So far 26 states have implemented Obama's program. Utah is one of 24 states that have yet to approve an expansion and one of three states currently debating Medicaid expansion. The state's sluggishness in securing the $258 million available for Medicaid expansion has drawn criticism from some who say there is a pressing need to help the uninsured.

At stake is coverage for approximately 110,000 low-income Utahns as well as the possibility of services cut for substance abuse prevention and treatment programs.

“We’re obviously very anxious to get this done in a timely fashion, but we’ll do it as quick as we can and we’ve got to make sure that the Legislature understands, that all their questions have been asked and answered and then we’ll move ahead,” Herbert said.

For some, that may not be soon enough.

Salt Lake County behavioral health services has seen a surge in those requesting treatment since the onset of the Affordable Care Act. The county is required by law to match 20 percent of legislative appropriations and has overmatched almost to the dollar, but the funds it puts forth are still not meeting the demand.

"We don't have the money anymore to do this," said Patrick Fleming, director of substance abuse at Salt Lake County behavioral health services.

In January, the county will cut 12 percent, or a total of $1.5 million, from 32 agencies such as Valley Mental Health, Odyssey House and the Boys and Girls Clubs, which provide treatment, counseling and other services for at risk populations, county officials said this week.

The cuts would impact 3,200 people, including 570 clients who receive treatment. The county was banking on the passage of the Healthy Utah plan to fill in the funding gap created by the cuts. If the expansion is not already in place, there may be a gap in services for those in need.

“That’s why we were so keen on the governor’s plan," Fleming said. "It really allows families to be on one plan. It requires a work element. It requires a co-pay. But more important than anything else, it keeps Utah tax dollars here in Utah. It keeps Salt Lake County tax dollars here in Salt Lake County,” he said.

It is estimated that taxpayers in Utah are paying up to $700 million for the Affordable Care Act. Those in the state will not see any return on this payment until some form of Medicaid expansion is approved.

In April, a BYU poll showed that most Utah voters support Medicaid expansion, with 43 percent behind Herbert's plan and 33 percent for the original plan under the care act, also known as Obamacare.

In addition to this, several community groups in Utah, including public policy consulting group Notalys and Utah Health Policy Project, will release results from a public opinion poll Tuesday that shows majority public support for Herbert's plan.

"When the majority of Utahns say we need to do something, we need to do something," said Rep. Rebecca Chavez-Houck, D-Salt Lake City.

She is part of the Utah Health Reform Task Force, consisting of 11 legislators and three support staff members. In May, Utah Department of Health Director David Patton told members that he expected to have a resolution in place by the end of summer.

Chavez-Houck said she s concerned about any potential delays, including a possibility of what she calls "deal breakers" if any aspect of the Healthy Utah plan is not approved.

"We don't want coverage to be delayed any longer than necessary … because for us the ultimate goal is getting people covered and getting people well," she said.

Republican members of the committee and Republican House and Senate leadership were not immediately available for comment Friday. In late May, the Legislature's GOP majority said it would not want to address Medicaid expansion in what may be a one-day special session but would prefer to wait until the Legislature begins at the end of January.

Email: wevans@deseretnews.com

Twitter: whitevs7

1. DN Subscriber
Cottonwood Heights, UT,
June 13, 2014

It's a trap!

Don't do it, we will never be able to pay for all the stuff you will be committing future Utah taxpayers to do, with the absolute certainty that Washington will be paying less and less each year-- while imposing additional mandates.

Again, it is a trap!

2. My2Cents
Taylorsville, UT,
June 14, 2014

Hold on Governor, not so fast, this is not your call or demand to make. Before committing the lowly tax payers of Utah to more oppressive taxation and unemployment and loss of jobs we must not get hasty in your maniacal midlife crises crazy actions.

It is up to the peoples representatives and matching cost overhead we cannot support making this expansion into an albatross tax fund. Representatives must obey the people to make this choice, the movement is to a more conservative approach to govenremnt spending including in health care. Downsizing state and federal government means eliminating government in social programs and civil needs. Individuals must provide for themselves and doubling of wages is not a tax burden.

Its a loose loose situation to throw more money at a health care system that is a failure. Romney care of Utah is a tax burden not suitable to the needs of the tax payers although its a blessing to illegal aliens and professional welfare dependents and for uncontrolled extremely costly medicaid/hospital providers.

There must be no passage of this expansion since the ACA and the fraudulent Utah health care exchange will be revoked and repealed by January.

3. There You Go Again
Saint George, UT,
June 14, 2014

So soon?

4. Icarus
Dallas, Texas,
June 14, 2014

Unbelievable that a governor of a conservative state would be pushing for this. Must be a lot of campaign contribution from hospitals at stake.

The saddest thing is that this will trap the poor in a government-run program that a study in Oregon showed the poor better off health-wise without Medicaid than with it.

It's the typical liberal response--the government has done such a poor job with healthcare (VA, Obamacare, etc.), let's expand it.

5. humbug
Syracuse/Davis, UT,
June 14, 2014

I am bothered by the work requirement. Students in college are "working." They just don't get a pay check. Non-working spouses may be "working" by providing child care for their children. But, they don't get a pay-check. Mentally ill persons may not be able to work without health care first.
If these persons end up in the hospital, and they don't have health coverage, then who pays the bills? The hospitals write the bill off, and shift the costs to others. Ultimately, we pay for their care via medicaid, or higher insurance premiums.
Some people are not able to work because of fragile health issues. Who decides what qualifies a person as fragile? We then need a whole bunch of persons to make these decisions and these persons have to be paid. This increases the cost of running the program.