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SALT LAKE CITY — Gov. Gary Herbert signed a bill Tuesday instructing the Department of Health to seek large-scale Medicaid expansion in Utah, which state officials say would expand coverage eligibility to everyone in the state up to the federal poverty line.
Herbert was flanked by Senate President Wayne Niederhauser, R-Sandy, and House Speaker Greg Hughes, R-Draper, for a signing ceremony at the Capitol.
The governor reflected on failed efforts in recent years to expand Medicaid in Utah, saying "it's been a long journey, it's had its twists and turns, its bumps and bruises, to get us to this point today.
"The goals have always been the same. We want to provide access to affordable health care for all of our people, but particularly for those who are most vulnerable in society who need a little helping hand," all while being responsible with the state's budget, Herbert said.
Herbert was also joined by Rep. Robert Spendlove, R-Sandy, and Sen. Brian Zehnder, R-Holladay, who were the sponsors of HB472.
The two of them garnered enough support for the bill in the recently concluded legislative session by assuring fellow state lawmakers that the bill was structured to spend no new state money and that it included a safeguard allowing Utah to rescind its Medicaid expansion if the promised federal fund matching rate were to fall below 90 percent.
"Now we have a chance to do this the Utah way," Zehnder said Tuesday. "It prevents cost overruns and reduces risk."
The new law instructs Utah's Department of Health to apply for a Medicaid expansion waiver from the federal government by Jan. 1 of next year.
The application will request that federal Medicaid funds be made available for expanding insurance coverage to all Utahns up to 100 percent of the federal poverty line, which would make health insurance coverage newly available to, according to an estimate from the governor's office, about 60,000 Utahns.
Honored to sign H.B.472 into law this afternoon. This legislation could help bring health care coverage to 60,000 Utahns. #utpolpic.twitter.com/LWDvLTAySA
— Gov. Gary Herbert (@GovHerbert) March 27, 2018
The bill's supporters say it will accomplish a commonly held goal of lawmakers and advocates to fix the so-called coverage gap that exists for those who are too poor to qualify for critically important subsidies on health plans offered on the federal exchange and yet earn too much to qualify for Medicaid.
Stacy Stanford, a policy analyst for the Utah Health Policy Project think tank and health insurance enrollment hub, contended Tuesday that the state's request is overwhelmingly likely to be denied by federal authorities. The bill signed into law by Herbert "provides a false promise and a false hope to a lot of Utahns," Stanford said.
"I wish that this was something I could be celebrating," she said. "(But) it's something that's destined for failure."
Stanford said that's because the federal government has never approved a Medicaid expansion to only 100 percent of the federal poverty level at a 90-10 funding match rate, and that beyond that there's "not a path for legal approval" of such an expansion — regardless of which presidential administration is at the reins.
"It's just destined for denial, unfortunately," Stanford said.
Niederhauser doesn't see it the same way. He believes the current presidential administration has made it clear that it's possible the terms outlined in Utah's request for Medicaid expansion could be approved.
"We've gotten some indications from Washington that they will consider a waiver for us, so we're going to give it a shot," he said at the signing ceremony. "Because it's important for us to get as many (as possible) of those in (the coverage) gap access to health care."
