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SALT LAKE CITY — Utah lawmakers continue to work on a plan to cover the state's uninsured but don't anticipate striking any kind of deal before August.
Upon failing for a second year to come up with a feasible alternative to the full Medicaid expansion outlined in the Affordable Care Act of 2010, a team of four lawmakers, Utah Gov. Gary Herbert and Lt. Gov. Spencer Cox set out in March to negotiate a deal.
"We are working well together," Utah House Speaker Greg Hughes, R-Draper, told a gathering at the Utah Taxes Now Conference in Salt Lake City on Thursday.
Hughes said the team's half-dozen meetings, including with the federal administration, have been productive, informative and educational.
"Our end goal is to get it right," he said, citing concerns about balancing the state's budget.
Hughes and some other conservative members of the Utah Legislature don't want to roll out a program that ends up either costing the state too much in the end or requires them to end it altogether.
"I think you have to seriously contemplate what it means to people's lives when you make promises, particularly as a state, and then you don't back it up," Hughes said. "If Congress didn't act, it comes on this state and how we administer this program, where the public will expect answers and expect responsibility. The buck stops with us."
Another concern, said Sen. Brian Shiozawa, R-Cottonwood Heights, is that in states that have expanded Medicaid benefits, more people have enrolled than originally projected, which likely results in increased costs to run the program.
I think you have to seriously contemplate what it means to people's lives when you make promises, particularly as a state, and then you don't back it up. If Congress didn't act, it comes on this state and how we administer this program, where the public will expect answers and expect responsibility. The buck stops with us.
–Greg Hughes, Utah House Speaker
But, Shiozawa said, those states have not necessarily complained to the feds about the deal, as they have experienced economic benefits, according to U.S. Health and Human Services officers.
"If more people enroll … they see it as a good thing because there are fewer people uninsured. They don't worry about the money or a budget. It's another entitlement program and the money will be there as far as they're concerned," Rep. Jim Dunnigan, R-Taylorsville, who is also part of the team he called the "gang of six" negotiating a plan for Utah with the governor, said Thursday during a Health Reform Task Force meeting on Utah's Capitol Hill.
The federal government has said it would cover at least 90 percent of the expansion to people who earn up to 138 percent of the federal poverty level, though local lawmakers have expressed concern that not only might the money not be there into perpetuity, but the remaining 10 percent of costs could cripple the state's financial situation. If the state expands to cover fewer people, up to 100 percent of the federal poverty level, the state will bear the brunt of those costs.
Herbert and his team have pledged to come to a resolution by July 31 and he will then call a special session for the consideration of lawmakers. Dunnigan said he doesn't expect anything sooner than August.
"There's a lot of work to do," he said, adding that "new ideas" have come out of the ongoing discussion.
The group has not released specifics about any of the negotiations.
"If we do this, we've got to get it right," Shiozawa said Thursday.
He said the state really only has two options: Do nothing and continue paying high costs for lower quality health care outcomes and subsidizing unnecessary emergency room visits, or expand benefits responsibly.
"We are going to use care, we are going to use all that ability that we hold, all that we can do, to predict where this could go, to protect our state and our taxpayers and citizens of Utah and still take advantage of this program," Shiozawa said.