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SALT LAKE CITY — Utah officials confirmed in an emailed press release Saturday that the White House would not approve the state's most recent, not-yet-submitted, Medicaid waiver.
"Late Friday the State of Utah received a call from the White House informing state leaders that its most recent Medicaid waiver request, which had yet to be formally submitted, would not be approved," the statement, by Gov. Gary Herbert, Utah Senate President Stuart Adams and House Speaker Brad Wilson, said.
It continues on by reassuring Utahns relying on Medicaid that they would still be covered under phase one of SB96, which went into effect on April 1, 2019. This allows for coverage for Utahns living up to 100 percent of the federal poverty level, with the federal government paying for 70 percent and Utah paying for 30 percent of the coverage. The waiver that was not approved would have requested the federal government fund 90 percent and the state 10 percent of Medicaid coverage. SB96, according to the release, has funded coverage until June 30, 2020.
"We contemplated possible scenarios like this one, and SB96 ensures the program moves forward as we navigate the complicated federal rules and regulations involved in Medicaid," the statement reads. "In the coming days and weeks, the governor and legislature will work in close partnership to evaluate the current situation to ensure Utah continues to provide a Medicaid program with long-term fiscal sustainability."
The statement came hours after a story from The Washington Post broke Friday, reporting that the Trump administration would not grant Utah or other states “generous federal funding” to expand Medicaid programs, even though an early version of Utah’s Medicaid expansion plan received federal approval in March.
According to anonymous “senior officials” who spoke to the Post, the administration said the entire Affordable Care Act, which expanded health insurance to around 20 million Americans, is unconstitutional and White House advisers argue it’s not logical to grant the federal funding if the law should be overturned altogether. A decision from the 5th Circuit Court of Appeals on the constitutionality of the ACA is expected to be decided in the near future, the Post reports.
The Utah Legislature passed the replacement to the voter-approved Proposition 3, which would have fully expanded Medicaid, earlier this year. The Centers for Medicare and Medicaid Service approved the first phase of Utah's program earlier this year. Under this plan, the federal government pays 70 percent and the state covers 30 percent of Medicaid coverage.
The plan extended coverage for Utahns earning only up to 100% of the about $12,000 federal poverty rate, rather than the 138% which would’ve been covered in the full expansion recommended in Proposition 3.
The White House did not issue a comment on The Washington Post’s report and instead referred questions to CMS.
A CMS spokesperson said in an emailed statement that, while they support state flexibility in Medicaid redesigns, "unfortunately, this would invite continued reliance on a broken and unsustainable Obamacare system."
The statement continues, "While we have carefully considered these requests, CMS will continue to only approve demonstrations that comply with the current policy."
CMS added it "will continue to support state efforts to design reforms that promote the objectives of the Medicaid program while ensuring greater fiscal and programmatic accountability."
Utah's alternative Medicaid expansion plan imposes certain requirements on enrollees, requiring different terms from the Affordable Care Act. Earlier this year, a federal judge struck down Medicaid work requirements in Kentucky and Arkansas, leading critics to ponder the possibility of whether Utah's program could be legally challenged.
Tom Hudachko, spokesman for the Utah Department of Health, told KSL in an earlier interview in March that that portion of Utah's program isn't expected to be rolled out until Jan. 1, 2020, so the approval likely wouldn't be affected by the court case.
As of Friday night, the denial had not affected Utah’s plans to submit a funding request to CMS, according to health department officials.
“We’re still preparing to submit our waiver as directed by state legislation passed this year,” Hudachko told The Washington Post. “We have not received any indication, one way or the other, how CMS may act on the waiver once we do submit it.”
The health department declined to comment further on whether or not they still planned to submit a waiver after the governor's statement was released Saturday.
In response to The Washington Post’s report, Utah Health Policy Project released a statement saying without the 90/10 match, Utah's Medicaid expansion waiver is "dead in the water."
“It’s time to implement Proposition 3 as approved by Utah voters and as directed by SB96. SB96 says if there is no wavier approval, then the state will go back to Proposition 3 with some fiscal adjustments that ensure sufficient long-term funding," said Matt Slonaker, executive director of Utah Health Policy Project, in a statement. “All of the sudden this is really simple: Utah should just pull the waiver and avoid a drawn out process.”
