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Lawmakers get first look at new Medicaid expansion plan

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SALT LAKE CITY — Lawmakers got their first look Tuesday at what's being called UtahAccess+, the new Medicaid expansion plan put together by Gov. Gary Herbert and Republican legislative leaders.

No action was taken on the plan, unveiled in closed Republican caucuses in the House and Senate, that would bring some $450 million in federal funds to Utahns available under President Barack Obama's health care law.

The public, along with the health care providers who'll be taxed to pay the state's share of the program's cost, will get an opportunity to weigh in on the plan next week at a Health Reform Task Force meeting.

Herbert has said he expects to call a special session of the Legislature to consider the plan, the result of months of private meetings with House Speaker Greg Hughes, R-Draper; Senate President Wayne Niederhauser, R-Sandy, and key lawmakers.

The plan is similar to the governor's Healthy Utah alternative to Medicaid expansion that passed the Senate but failed in the House during the 2015 Legislature, except that it now includes a funding source other than taxpayers.

Hospitals, doctors and a dozen other provider groups would be taxed starting in 2017 to raise some $35 million toward the state's share of the program's cost. By 2020, that share will amount to 10 percent of the program.

For hospitals, that initially could be as much as $4.5 million, while doctors would each pay about $800. The state would contribute more than $19 million, mostly for children who should already be receiving Medicaid but have not been enrolled.

The list of providers also includes managed care organizations, prescription drug companies, those who offer psychological, home health care and ambulance services, podiatrists, opticians, chiropractors and nurses.

Some 95,000 Utahns would be covered by the plan, which utilizes private insurance. That includes 63,000 adults earning below the federal poverty level in the so-called coverage gap because they receive no health care subsidies.

Another 31,500 children and adults considered "woodwork" because they qualify for Medicaid but have not signed up to receive it are also expected to seek coverage as a result of the plan.

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The details about the plan made public Tuesday have yet to be drafted in bill form.

Once the bill is ready, even if it were approved in mid-October, the soonest a special session would likely be set, it is not clear how long it would take to implement the plan. The Obama administration would still have to approval a number of waivers.

And just how much support there is for the plan among lawmakers remains to be seen.

Niederhauser and Sen. Brian Shiozawa, R-Cottonwood Heights, who also worked on the plan, both made pitches to Senate Democrats, who did not close their caucus meeting to the public.

"This is a bunch of new provider taxes. This is not going to be easy for any Republican caucus," the Senate president told the Democrats, adding that their votes would be needed.

Hughes wouldn't comment on the plan following a three-house caucus meeting.

"I have nothing to say," he told the Deseret News before heading to what his aides described as a town hall meeting with doctors in Draper.

House Majority Leader Jim Dunnigan, R-Taylorsville, stopped short of telling reporters he supported the plan, stressing instead that House leadership was not "pushing or pulling our caucus into a position. … They need to own it."

Dunnigan is the chairman of the task force that will hold a public hearing on the plan at 3 p.m. next Tuesday in Room 30 of the House Building on the Capitol grounds. He said another caucus meeting will be held a week later to poll members.

Lawmakers are already feeling pressure from both opponents and supporters.

Democrats and Republicans agree Medicaid expansion is an issue that needs to be addressed, but Republicans have shut out Utah families from the process. Today, Speaker Hughes, we say, 'Open these doors. Let Utahns have a voice.'

–Democratic Party Chairman Peter Corroon

National groups opposed to Medicaid expansion have been targeting some Utah lawmakers by contacting their constituents through mailers, telephone calls and door-to-door canvassing.

"It's legislators who are persuadable and who need pressure to do the right thing," said Calvin Moore, regional communications manager for the Virginia-based Americans For Prosperity.

Moore would not name what he said were "a dozen or so" members of the Utah Legislature who meet that criteria, though he provided a copy of a new mailer that was aimed at the House majority leader.

The personalized mailer warned a resident in Dunnigan's district that his "Medicaid expansion tax bill" adds up to $328 million over the first decade, paid for through a tax "passed on to sick and suffering Utahns" that means "more Obama, less care."

The organization, the main political advocacy group for the Koch brothers, billionaire industrialists playing an increasingly prominent role in Republican politics nationwide, has a Utah chapter.

Neither Moore nor Evelyn Everton, state director of the Utah chapter, offered an alternative for those Utahns in the coverage gap beyond saying any program should be state-based rather than rely on federal funds.

The Utah Democratic Party and the Alliance for a Better Utah held a news conference outside the doors of the House GOP's closed caucus, criticizing Republican lawmakers for deciding the future of Utah Medicaid expansion in secret.

"Democrats and Republicans agree Medicaid expansion is an issue that needs to be addressed, but Republicans have shut out Utah families from the process," said Democratic Party Chairman Peter Corroon. "Today, Speaker Hughes, we say, 'Open these doors. Let Utahns have a voice.'"

Robert DeBirk, executive director of the Alliance for a Better Utah, criticized the Legislature for missing "countless deadlines" while trying to come up with a solution. He spoke of Carol Frisby, a Taylorsville woman who had been diagnosed with colon cancer after being unable to afford a colonoscopy screening ordered by her doctors years earlier.

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Frisby died the Monday before the governor's group announced they would not meet their self-imposed July 31 deadline to come up with a plan.

"Let's remember that this conversation is, at its core, about saving lives and helping our fellow Utahns," DeBirk said, citing a Harvard University study that shows one Utahn dies every two to three days because of lack of insurance. "This is about saving tomorrow's Carol Frisby."

DeBirk also announced the launch of an online "Medicaid clock," which counts the days and minutes that have passed since Jan. 1, 2014, when Utah first had access to federal funds that would have expanded Medicaid.

Tuesday afternoon, it tallied just hours less than 637 days.

"We've also estimated the number of lives regrettably and irretrievably lost since the opportunity to expand Medicaid was first made available," he said.

The clock tallied 349 deaths Tuesday afternoon.

Earlier, members of ADAPT, a disability rights activist organization, blasted air horns and chanted outside of the House caucus meeting and inside the governor's office, demanding Medicaid expansion, and more specifically, implementation of measures to allow individuals with disabilities to live in their own communities rather in nursing homes.

At one point, protestors opened the door to the Capitol board room and shouted at members of the House GOP caucus. The Republicans ended up moving to another meeting room.

Contributing: Katie McKellar, Nicole Vowell

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