Utah Gov.: Medicaid negotiations moving forward

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SALT LAKE CITY (AP) — Utah's low-income residents are a step closer to buying private insurance through federal subsidies, Gov. Gary Herbert said Wednesday.

Herbert, who proposes a state Medicaid alternative to help insure 110,000 residents in the private market instead of the government program, said he's encouraged by talks with federal officials earlier this week.

"We were received very well," Herbert said, "and indications are that we can in fact resolve this over the next couple of months."

Federal officials didn't see any "deal breakers," Herbert recounted, in a rough outline of the state plan. He's hoping for an agreement sometime in June, he said. If that happens, he will pitch the plan to the Legislature, which must approve a deal with the federal government for it to become official.

To get federal assistance in buying insurance, the proposal will likely require state residents who are able to work to show that they have a job or are searching for one, Herbert said. It could include copays of at least $3 or $4 per doctor's visit, said Herbert and David Patton, head of the Utah Department of Health. Those above the poverty level will likely need to cover at least part of their premiums under the Utah proposal.

Traditionally, federal officials have resisted work requirements.

Herbert, a Republican, is asking for federal grants to create a three-year pilot program.

The state estimates the program would cost $258 million in federal in the first year and about $280 million by the third year.

But the first-year figure is "not a frozen number," Herbert said Wednesday. He conceded that many of the details need to be worked out. He has yet to outline many specifics or exactly how much flexibility he's seeking.

The Centers for Medicare and Medicaid Services has declined to comment on pending discussions with Utah.

Under President Barack Obama's health care law, the federal government is offering to pay the full cost through 2016 for states expanding Medicaid eligibility to people earning up to 38 percent above the federal poverty level. Reimbursements are scheduled fall to 90 percent by 2020.

The Obama administration has approved "private option" plans similar to Herbert's in states like Arkansas, but with some restrictions.

There is no deadline to work out a plan.

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