Utah among states that may lead in Medicaid reform


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SALT LAKE CITY -- A Utah state senator is trying to change the growing costs of Medicaid with the help of former governor Mike Leavitt.

The amount of money government spends on Medicaid is driving the reform effort. Medicaid costs grow about 11 percent every year, a path Sen. Dan Liljenquist, R-West Bountiful, says is unsustainable.

Utah Medicaid Funding (% of general fund)
2001: 9%
2011: 18%
2020: 36%

"We put $40 million more ongoing into Medicaid but did not fund education growth," he said. "It is the Pacman of our budget and it's out of control."

Ten years ago, the state of Utah spent 9 percent of its general fund budget on Medicaid. This year, the state will spend 18 percent of its general fund budget, more than $500-million toward a total of $1.8 billion.

By 2020, Medicaid could be as much as 36 percent of Utah's general fund budget.

The Legislature unanimously approved the first step of Medicaid Reform this year, requesting waivers from the federal government to make changes.


(Medicaid) is the Pacman of our budget, and it's out of control.

–Sen. Dan Liljenquist


Under the current system, patients can go to any health care provider that accepts Medicaid. It's procedure-based, and encourages duplication or neglect, expensive emergency room visits or surgery.

The new system is like an HMO. Providers would get a set amount to manage a patient's health.

Public health advocates are cautious about details, but like incentives to keep patients healthy.

Shanie Scott, Medicaid policy director with the Utah Health Policy Project said, "This will really change the way we think about health care and the way we take care of our health."

It's in the first stages, but former Utah governor and Health and Human Services administrator Mike Leavitt says states like Utah may play a part in larger reform nationwide.

"There is a serious appetite for innovation in Medicaid," he said. "It's clear to those in Washington that innovation won't happen in Washington, it will happen in states."

There are plenty of questions about what Medicaid reform will mean to people's health care. But the reality is that some kind of change to Medicaid will happen sooner or later.

E-mail: rpiatt@ksl.com

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