Medicaid expansion: New details emerging, poll shows Utahns are split

Medicaid expansion: New details emerging, poll shows Utahns are split

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SALT LAKE CITY — New details are emerging about what Gov. Gary Herbert and legislative leaders want to see in a Medicaid expansion plan even as a poll shows Utahns are split over whether lawmakers will come up with the "right" solution.

Thursday, House Majority Leader Jim Dunnigan, R-Taylorsville, revealed the group is proposing taxpayers cover $25 million of the cost of providing health coverage to children already eligible for Medicaid but haven't been signed up for benefits.

"It's a significant piece," Dunnigan said, amounting to nearly one-third of the $78 million the state is expected to eventually have to contribute toward the program to receive hundreds of millions of dollars in federal funds.

Previously, the only source of revenue discussed was new taxes on the medical community. Herbert has said the plan calls for hospitals, doctors, drug companies and other beneficiaries of the federal funds to pay 7 cents for every $1 received.

"That way, we don't have to raise taxes and the risk and the benefit are borne by those who are the beneficiaries of the money," the governor said last month. "The theory is the ones who benefit should be the ones who pay for it."

Herbert spokesman Jon Cox said Thursday that "the woodwork piece is a critical component" of the plan. The term "woodwork" refers to Utahns who are expected to seek benefits they already qualify for once the new plan is implemented.


Count the governor among those Utahns who believe the Legislature will be able to arrive at a solution that is right for the state.

–Jon Cox, spokesman for Gov. Gary Herbert


It could add to the price of accepting the money available under President Barack Obama's health care law and has raised concerns about sustainability. The state will eventually have to cover 10 percent of Medicaid expansion costs.

Dunnigan said nearly all Utahns who fall into the "woodwork" category are children, although Utah also offers Medicaid benefits to the disabled, pregnant women and families with incomes that fall below 50 percent of the federal poverty level.

All of the new benefits under Medicaid expansion, Dunnigan said, will go to adults.

The group has already agreed to provide coverage to all Utahns earning less than 138 percent of the federal poverty level, as required to receive the maximum match of federal funds.

The plan for using that money to provide coverage to low-income Utahns, including those who receive no federal subsidies without Medicaid expansion, is being negotiated privately by the governor and GOP lawmakers.

Herbert has said he hoped the plan would be ready as soon as the end of September and that he expects to call lawmakers into special session to consider the plan before the 2016 Legislature, which begins in late January.

A UtahPolicy.com poll by Dan Jones & Associates found Utahns are nearly evenly divided when asked if they "believe that lawmakers will still be able to come up with the right Medicaid expansion plan that fits Utah's needs."

The same number, 37 percent, answered they "probably" did or "probably" didn't agree. The poll, conducted Aug. 7-14 of 500 Utahns, has a margin of error of plus or minus just under 5 percent.

"Count the governor among those Utahns who believe the Legislature will be able to arrive at a solution that is right for the state," Cox said.

RyLee Curtis, senior health policy analyst at the Utah Health Policy Project, said the poll indicates the public may be getting tired of waiting for a plan.

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"I think that might be the fatigue setting in," Curtis said.

Still, she said, that's countered by the fact that the GOP governor and lawmakers haven't given up on finding a plan even though they failed to agree on Herbert's Healthy Utah proposal last session.

"I think a lot of people still have faith the (group) can come up with the right decision because they've come so far," Curtis said. "They're still meeting and that's good news."

University of Utah political science professor Matthew Burbank said the poll results suggest there's a lot of uncertainty surrounding the plan because so little has been made public.

"This is where the details matter a huge amount," Burbank said. "And what we've heard from that group so far is, 'We have a basic framework.' But we haven't seen any details."

Most people aren't following the discussions about funding, he said, waiting instead for the final plan to be unveiled. Finding a way to pay for the plan, however, is going to be key to winning legislative approval.

Burbank said he has his own doubts about the ability of the group to come up with a plan.

"I honestly don't know," he said. "I think if this was going to happen, it would have already happened. At this point, there's some risk it's getting bogged down in details that are really hard to iron out."

Dunnigan said it hasn't been easy to get this far.

"It's very complicated," he said. "It's more than saying, 'I do' at the altar. You have to live with this person afterward."

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Lisa Riley Roche

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