Medicaid is a national social program providing health insurance coverage for over 70 million low-income individuals, children, the elderly, and people with disabilities. All 50 states participate in the Medicaid program, which is designed to provide insurance for those whose income is insufficient to pay for health care. The federal government matches funds used by the states to provide health care for those who meet eligibility requirements, which are determined by individual states in addition to the services that are covered under Medicaid.
Under the Affordable Care Act, each state was required to expand the program beyond the current minimum federal guidelines to cover all adults with incomes up to 133% of the federal poverty line (about $33,000 for a family of four). In return, the federal government would have paid for 100% of the costs of this expansion until 2016 and 90% of the costs after 2020, with states only having to pay 10% of these expansion costs. However, in National Federation of Independent Business v. Sebelius, the U.S. Supreme Court ruled on June 28, 2012 declared the Federal government cannot coerce States to expand Medicaid, effectively giving them the option to expand Medicaid or continue with their current programs.
To date, 31 states and the District of Columbia have chosen to fully expand Medicaid. Although there have been several efforts to expand Medicaid in Utah, state lawmakers have repeatedly rebuffed these efforts, citing potentially unpredictable costs to the state. Under Governor Herbert’s “Utah Access Plus,” low-income Utahns would have received financial assistance to purchase private health insurance, in addition to increasing taxes on health care providers. However, Utah House Republicans killed the compromise in a closed-caucus meeting. This followed the Utah House also killing Governor Herbert’s “Healthy Utah” plan that would have fully expanded Medicaid.
In 2016, in an attempt to “do something,” the Utah Legislature passed a small extension of the state’s already existing Medicaid program. HB 437, “Health Care Revisions,” from Rep. Jim Dunnigan, was designed to provide coverage for around 16,000 Utahns, specifically focusing on childless adults suffering from chronic homelessness, mental and physical handicaps, drug addiction, and involvement in the justice system, although the estimated coverage was later reduced to around 10,000 Utahns. The Utah Department of Health announced they would be able to move forward with covering somewhere between 3,000 and 5,000 of these individuals; however, the state is still waiting for the remaining Medicaid waiver to be approved by the Trump administration.
The American Health Care Act (AHCA), proposed by Congress to repeal and replace Obamacare, would repeal the Medicaid expansion program after 2020. Those who have gained health coverage due to Medicaid expansion would be able to keep their Medicaid coverage after 2020 as long as they continue to qualify.
Alliance for a Better Utah has been an ardent advocate for the full expansion of Medicaid to protect the over 100,000 Utahns in need of healthcare insurance coverage. In 2015, we planted hundreds of crosses across the lawn of the State Capitol Building, representing the estimated number of those who have died as a result of the failure to expand Medicaid. Our lawmakers’ refusal to provide for these low-income and struggling individuals has real and dire consequences. We have a duty to provide for the needy among us and our state representatives are currently failing at that duty.
Advocates for Utah’s homeless and mentally ill are questioning the Legislature’s partial Medicaid expansion plan (HB 437) after learning it will cover 6,000 fewer people than originally promised.
The Alliance for a Better Utah responded to news of cuts to the estimated coverage of Rep. Dunnigan’s Medicaid plan that was passed during the 2016 Legislative Session. Although originally estimated to cover 16,000 low-income individuals, the Utah Department of Health announced that Medicaid would be extended to only 10,000 individuals, leaving another 6,000 Utahns without access to healthcare.
More than a few lawmakers were celebrating as the 2016 legislative session drew to a close, patting themselves on the back for finally passing “Medicaid expansion.” The problem, however, as critics have fiercely pointed out, is that what the Legislature passed actually has nothing to do with the Medicaid expansion program of the Affordable Care Act.
The state of Utah would disgrace itself in the eyes of its people, its history, its posterity and the civilized world if it were to approve Rep. Jim Dunnigan‘s latest version of what he is peddling as a measure to expand health care access to the poorest of the poor.
So, of course, that is exactly what the state is about to do.
“It has now been 771 days since Utahns could have first received coverage from Medicaid expansion,” said Chase Thomas, policy director for the Alliance for a Better Utah. “As the Legislature continues to delay acting on Medicaid expansion, the costs continue to add up, and those costs have been staggering.”
Three-hundred-and-sixty-one white wooden crosses were planted in the lawn of the Utah Capitol on Wednesday, representing the estimated number of people who have died because of the Legislature’s failure to expand Medicaid, as advocates kept pressure on lawmakers to act.