SALT LAKE CITY — More than a dozen community and faith leaders stood behind Utah Gov. Gary Herbert on Thursday as he launched his campaign for an alternative to Medicaid expansion in Utah.

"This is really just the beginning," Herbert said, adding that he's studied alternatives for a year and a half and has been lobbying the federal government for flexibility in implementation at least that long. He said his Healthy Utah plan aims to provide coverage for Utah's uninsured population in a "unique to Utah" way.

"Utah is known for being a caring community," Herbert said. "We do care about our neighbors."

The plan is one of several being considered by state lawmakers, who will debate its tenets in the upcoming legislative session. It was presented to the state's Health Reform Task Force on Thursday.

New numbers presented to the governor Tuesday, however, show that more Utahns would receive coverage under his plan than originally anticipated, meaning the costs to the state are projected to be higher. Those numbers, provided by an actuarial firm, have not been vetted by state officials but were somewhat startling to task force members.

Herbert said his plan was approved by the federal government as a pilot program, to be terminated at the state's discretion. But that impending decision doesn't sit well with some lawmakers.

"We will have a choice to discontinue coverage for individuals who will be newly covered under that plan and have not had insurance up until now, or absorb $93 million as a state," said Rep. Dean Sanpei, R-Provo, who sits on the Health Reform Task Force. "That is disheartening as a choice."

According to the new numbers, about 63,000 adults in Utah are living below 100 percent of the federal poverty level, making less than $11,670 annual income, and are uninsured. They are not disabled or pregnant and do not have children in their homes, so they are not eligible for Medicaid, and they do not make enough to receive subsidies to help cover the costs of health care insurance purchased on the federal marketplace.

Previous studies have determined that about two-thirds of uninsured Utahns are working adults in low-paying jobs. Another portion of the uninsured are the medically frail, who are unable to hold jobs.

"Turning a blind eye is not the Utah way," Herbert said.

His Healthy Utah plan, the governor said, respects the taxpayer by utilizing tax money sent to Washington, D.C., to implement Medicaid programs. It also supports private markets by giving Utahns the opportunity to purchase locally managed health plans and providers.

Healthy Utah, Herbert also said, promotes individual responsibility, or the "can-do spirit" that he said is part of Utah's culture, as he has set forth co-payment models and premium assistance plans, as well as what he called an integrated job program that would help Utahns using the expanded health care system to "get off government assistance."

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Gov. Gary Herbert says he's made great progress negotiating an alternative Medicaid expansion plan with officials in Washington, D.C.

The plan, Herbert said, also "maximizes flexibility." He said Utah has asked for and received the most flexibility of any state, and it will be put to the test in the coming years if Healthy Utah is approved.

The governor, however, has not received an official waiver for implementation of his plan, only a written statement from the U.S. Department of Health and Human Services, saying it agrees with and will support all concepts negotiated so far. A waiver would require "months" to write up and obtain, according to Utah Department of Health Director David Patton.

He said the state would realize some savings from programs no longer necessary if Healthy Utah were to take effect, including behavioral health services, the Primary Care Network and inpatient care for prisoners, totaling about $12 million in the first year.

Patton also suggested imposing industry-wide assessments to help make up costs.

Individuals covered under Herbert's plan, he said, would assume a cost-sharing responsibility, depending on their income, including co-payments for services. Those above 100 percent of the federal poverty level would pay co-pays and premiums. Emergency room services would bear a $50 co-payment from Healthy Utah members.

If members refuse to take part in skill-building programs that would enhance job placement, Patton said the state could consider withholding state benefits such as driver's licenses.

"The objective of this whole idea is to improve the health conditions of individuals and that should have a monetary benefit as well," Patton said.

Rep. Francis Gibson, R-Mapleton, clarified that Utah would essentially have to impose a new tax to pay for ongoing costs of implementing Healthy Utah, or any version of Medicaid expansion.

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Despite the uphill climb Healthy Utah faces to gain support of legislators in the coming months, Herbert was propped up by business, faith and community leaders, including Bishop Gary Stevenson, presiding bishop of The Church of Jesus Christ of Latter-day Saints; Gail, Greg and Steve Miller; Lane Beattie, president of the Salt Lake Chamber; Scott Anderson of Zions Bank; Intermountain Healthcare CEO David Entwistle; and local homeless advocate and "Utah's Mother Teresa" Pamela Atkinson, among others.

The Most Rev. John C. Wester, bishop of the Catholic Diocese of Salt Lake City, who was also present, said he supports the plan because of his "belief and our Catholic dedication to protecting the sanctity and dignity of human life."

"Everyone needs access to affordable, high-quality health care," he said, adding that he has attended to many people who were in worse circumstances than they could have been with access to preventive care.

"No human being is expendable and no family is disposable," Bishop Wester said.

Utah is among the healthiest populations in the country, boasting low health care costs, according to University of Utah Health Care CEO Dr. Vivian Lee, who also stood in support of Herbert's Healthy Utah plan. She said the insurance investment would lead to healthier people and make a dent in the more than $100 million in uncompensated care that the hospital doles out each year.

Beattie called Healthy Utah the "fiscally responsible thing to do," as Utah could likely draw back a large portion of the $680 million paid to the federal government for implementation of the Affordable Care Act.

Herbert has said his plan is up for negotiation, and he said he "didn't get all that I wanted" from the federal government.

"It's a good proposal … better than anything else I've seen," he said.

Task force member Rep. Rebecca Chavez-Houck, D-Salt Lake City, said she doesn't want policy to get in the way of helping Utahns who need access to health care.

"We can do right by our citizens who have paid into the system and deserve coverage," she said, adding that the longer the Legislature waits to approve a plan, the longer people go without coverage.

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