Herbert expecting an 'OK' from feds on Medicaid expansion plan


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SALT LAKE CITY — Gov. Gary Herbert continued to be optimistic Wednesday that the federal government will sign off soon on his proposed alternative to Medicaid expansion following meetings in Washington, D.C., earlier this week.

Herbert told reporters federal approval should come in time for him to call a special session of the Utah Legislature this summer to accept the $258 million available for Medicaid expansion under the Affordable Care Act, also known as Obamacare.

But the leaders of the Utah House and Senate said the governor's plan is going to be a tough sell, especially in an election year for most lawmakers. The recently ended 2014 Legislature couldn't agree on a plan for Medicaid expansion.

A tough sell for Utah lawmakers

"It took us the whole session to get nowhere," House Speaker Becky Lockhart, R-Provo, told KSL News.

Lockhart, who may challenge Herbert in the 2016 governor's race, opposes taking the Medicaid expansion dollars.

She said it's "no surprise" the Obama administration would seem supportive of Herbert's plan.

"That is what they've wanted all along, is for states like Utah to do what they want us to do, which is full Medicaid expansion," Lockhart said.

It remains to be seen, the speaker said, whether the "significant opposition" in the House to the governor's plan to use the federal funds for a state-run program can be shifted.

Senate President Wayne Niederhauser, R-Sandy, said while the Senate is a "mixed bag" on Medicaid expansion, "there's a lot of work to be laid before we're intrigued by the idea" of approving the governor's plan in a special session.

"We just don't want to just come in and vote something down," Niederhauser said.

But the special session will highlight the controversy surrounding the Democratic president's signature health care plan just before the November election, he said.

"It's not mixed in with some other highlighted issues during the session. So there's a lot of attention that's going to be put on all our legislative members by constituents," Niederhauser said. "This is going to be a heavy lift."

How the plan would work

Herbert met with outgoing U.S. Health and Human Services Secretary Kathleen Sebelius and advisers to President Barack Obama during a three-day trip to Washington.

The governor told reporters Sebelius, who announced last week she is stepping down, said she saw "nothing in your proposal, governor, that would be a deal breaker." Her comment came as a "pleasant surprise," Herbert said.

"They saw nothing that would offend them in embracing the Healthy Utah proposal," he said, although concerns have been raised about the plan's requirements that recipients work, make co-payments and contribute toward their premiums.

Having those requirements, the governor said, "means the recipients will have some skin in the game. They have some involvement. It helps them to feel like it's not just a government dole. They’re paying at least partially their own way."

David Patton, executive director of the Utah Department of Health, said while details of the plan are still being negotiated, the additional cost sharing would be aimed only at Utahns earning above the federal poverty level.

"The governor is very sensitive about those who are in the group below poverty," Patton said, as well as the most medically frail who will likely continue to be covered by Medicaid under the plan.

The cost of Utahns participating in the plan is estimated at $400 a year, about 2 percent of their earnings. It is intended to cover those earning up to 138 percent of the federal poverty level, less than $11,500 annually for a single person.

Utah is one of only a handful of states that have yet to either accept or reject the Medicaid expansion to help cover health care costs for low-income residents, including those who otherwise wouldn't qualify for any subsidies.

Sen. Orrin Hatch, R-Utah, said he expects the Obama administration to accept Herbert's plan.

"They want to get as many states to sign up as they can," the state's senior senator said. "And Gov. Herbert is taking advantage of that. I believe they'll go along with it."

Contributing: Dennis Romboy and Richard Piatt

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