Let Them Eat Coal

Source: Salt Lake City Weekly

Medicaid Expan … er … Extension

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.

Lawmakers have already dithered away the years of free expansion Utah could have received had it joined the more than 30 other states who accepted full expansion. But now, instead of passing the type of expansion intended under the Affordable Care Act (which comes with a 90-10 payment match from the feds), lawmakers ended up passing what would more accurately be described as an “extension”: one year of Medicaid coverage for Utah’s chronically homeless and a few others.

Because it only extends to 16,000 of the most needy, the new law authored by House Majority Leader Jim Dunnigan, R-Taylorsville, will only be covered by the feds at the current 70-30 rate.

To qualify for Dunnigan’s new plan, one needs to be “chronically” homeless, recently released from prison or mentally ill. That doesn’t mean all of Utah’s homeless will now qualify, however, because the bill specifically says only those who have been homeless for more than a year will actually qualify. There are also income restrictions. Dunnigan’s bill set the income cap at $0 for Utah’s side, so a childless adult can only make up to 5 percent of the federal poverty level (about $49 per month) before earning too much to qualify. The income restriction applies no matter which of the three groups you fall into: chronically homeless, recently released from prison or mentally ill. Adults with children can only make up to 55 percent of the federal poverty level.

One of the most interesting things to come out of the debate around Dunnigan’s bill was the complete fracturing of the coalition that had stood so firm behind full Medicaid expansion for the past few years. While legislative Democrats and the Utah Democratic Party stood firmly in opposition to Dunnigan’s bill as not going far enough, Salt Lake County Mayor Ben McAdams and Salt Lake City Mayor Jackie Biskupski—Democrats who work directly with their homeless populations—were strongly in favor of the law, even holding a press conference with Dunnigan to lend their support. Homeless advocate Pamela Atkinson lent her name to the bill, but liberal advocacy group Alliance for a Better Utah strongly opposed it.

Utah Health Policy Project, on the other hand, remained very quiet during the debate, telling City Weeklythat it was remaining neutral because, while it agreed that getting coverage to the 16,000 “poorest of the poor” Utahns is a good thing, the nonprofit is concerned that lawmakers will look at this as a job well done and never again revisit the subject of Medicaid expansion. And there are still tens of thousands of working Utah families who don’t have health care. (Eric Ethington)

Read entire Salt Lake City Weekly article here.

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