SALT LAKE CITY — In the final day of debate in the Supreme Court case over the Affordable Care Act, much of the argument centered on the future of Medicaid. And that has the attention of the more than a quarter million people in Utah who rely on the benefit.

Kelly Colby, for example, struggles with a chronic condition that causes her a lot of pain. But her 19-month-old daughter, Leah, keeps a smile on her face — as does the knowledge that her ongoing medical bills are covered through Medicaid.

"I've had some health struggles, and with those I would probably have filed bankruptcy or been in a lot of debt with a lot of medical bills if I didn't have Medicaid," Colby said.

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Court appears split by ideology over health care

Concluding three days of fervent, public disagreement, a Supreme Court seemingly split over ideology will now wrestle in private about whether to strike down key parts or even all of President Barack Obama's historic health care law.

Kelly and Leah are among the 252,000 Utahns who rely on the state's Medicaid system. Most of the people on the program are children.

The debate this week in the Supreme Court over expanding every state's responsibility over Medicaid is a key issue: Most states, including Utah, are worried that the money the federal government is pledging for that expansion won't really cover the costs.

As it is, Utah spends more than $1.8 billion on Medicaid — three-fourths of it is federal funding, and the rest comes from the state.

Child health care advocate Lincoln Nehring, spokesman for Voices for Utah Children, is keeping a close eye on what happens next, because it's possible Medicaid's future might be up for debate if the court overturns the health care bill.

"It really puts families at risk, as we would really have to recreate a new health delivery system for low- and moderate-income families in our state."

The bottom line is, there is a lot riding on what the Supreme Court ultimately decides. A ruling in the case isn't expected until June.

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