House committee will hear Healthy Utah alongside own plan for Medicaid expansion


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SALT LAKE CITY — House leaders Tuesday reversed a decision not to allow Gov. Gary Herbert's Healthy Utah alternative to Medicaid expansion to be heard in committee, the same day their counterproposal was introduced.

House Speaker Greg Hughes, R-Draper, said he regrets that a strategy intended to push for a compromise on coverage for low-income Utahns that House Republicans could support "was misinterpreted only as having a hearing."

Hughes said even though both plans will be heard by the House Business and Labor Committee at 6 p.m. Wednesday, there still isn't sufficient support among the majority party members for Healthy Utah for the plan to pass the House.

"It is the case. We have to find a place where we can find support in the House. That's what I was expressing, and if it was taken in a different tone, I apologize for that," the speaker said.

His apology comes after nearly a week of controversy over his declaration that the House would not consider Healthy Utah after it passed the Republican-controlled Senate.

Hughes said the House was "done" with the GOP governor's two-year plan for using the federal funds available under the Affordable Care Act because it didn't have enough votes according to a poll taken in a closed-door House GOP caucus meeting.

Even as late as Monday, Hughes and House Majority Leader Jim Dunnigan, R-Taylorsville, told the Deseret News and KSL editorial boards they could not commit to Healthy Utah getting a hearing in the House.

The governor said Tuesday he believes Hughes responded to public concerns about Healthy Utah, a plan he first introduced a year ago and has spent months negotiating with the Obama administration.

"I think he’s hearing the cries out there, saying, 'Let us weigh in on it,'" Herbert told reporters, calling a hearing on his plan "part of the process, and as I've said before, process counts. It's important that we vet things openly and transparently."

Senate President Wayne Neiderhauser, R-Sandy, called the House holding a hearing on Healthy Utah "progress." He said Senate leadership has not had discussion with House leadership about the Medicaid proposals.

Asked it he thought the House scheduled the hearing to kill the bill, Neiderhauser said "possibly."

House Minority Whip Rebecca Chavez-Houck, D-Salt Lake City, said Democrats "are grateful the people of Utah spoke out to convince their representatives that Healthy Utah deserves a hearing."


It is the case. We have to find a place where we can find support in the House. That's what I was expressing, and if it was taken in a different tone, I apologize for that.

–House Speaker Greg Hughes, R-Draper


Chavez-Houck, a member of the Legislature's Health Reform Task Force that has being studying Medicaid expansion, said the new House plan was "cobbled together over the past two weeks" and "is not the way to go this late in the session."

HB446, Dunnigan's Utah Cares plan, uses traditional Medicaid and the state's Primary Care Network to provide limited health care to Utahns in the so-called coverage gap under the Affordable Care Act, those earning up to 100 percent of the poverty line.

The governor's Healthy Utah proposal, contained in SB164, sponsored by Sen. Brian Shiozawa, R-Cottonwood Heights, would cover Utahns earning up to 138 percent of poverty to qualify for a larger federal match.

There is disagreement between the House and the governor's office over how much the plans would cost the state, as well as over how many federal dollars each would bring to Utah.

According to figures provided by Herbert's staff, Healthy Utah would cover 126,500 Utahns by the 2017 budget year at a cost of $23.5 million and get back $971 million in federal funds.

The House, however, said Healthy Utah would cost slightly more than the governor's numbers and return fewer federal dollars to the state, less than $300 million in the first year.

The price tag for Utah Cares, according to the House, is $30 million in the first year, with $140 million in federal funds coming back to cover Utahns earning less than 100 percent of the federal poverty level.

The governor's office put the cost of Utah Cares slightly higher and the amount of federal dollars associated with the House plan much lower, at $32 million in the first year.

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Although there has been talk of a compromise approach to use the governor's Healthy Utah plan for two years and then revert to the House's Utah Cares plan, Dunnigan said "that remains to be seen."

He said it is "more prudent" to start with the more limited House plan and then expand to Healthy Utah or another plan in two years, when there will be a new president and potentially more flexibility.

Hughes said starting with the governor's larger program could be seen as "an attempt to grab more federal funds" before the state retreats to what the House sees as a more sustainable plan long-term.

"The problem with that is you’re talking about people" who could lose coverage if Healthy Utah was replaced after two years, Hughes said.

Healthy Utah is expected to cover up to 126,500 people, the governor's office said, while the House estimated about 60,000 low-income residents would get coverage under Utah Cares.

The governor called it "conservative common sense to not waste taxpayer dollars" by accepting less federal money to provide more limited coverage to fewer people, especially since Utahns are paying millions in related federal taxes.

"I think it’s legitimate to say, 'Let's start small and build up.' I understand the appeal of that approach," Herbert said. "Unfortunately, with this unique situation, we start small and a lot of people go without. So we ought to see what we can do."

Contributing: Dennis Romboy

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