Utah Lawmakers Seek to Roll Back Medicaid Expansion Passed by Voters

This article originally appeared in the Wall Street Journal. Read it in its entirety here.

Three months after voters in deep-red Utah approved a pair of ballot measures opposed by many
Republican leaders, the state legislature is on the verge of pulling both of them back.

In December, the GOP-dominated legislature replaced a voter-approved medical marijuana law with a
new version that more tightly controls access to the drug.

And this week, lawmakers are pushing a bill to restrict eligibility for a voter-approved expansion of Medicaid. The bill, which was approved by the Utah Senate on

Monday, is becoming a flashpoint in a fight over just how closely state leaders should hew to the will of voters.

Republicans in Utah’s capital say fixes to the Medicaid measure are necessary because the expansion of government health care for the poor would bore a hole in the budget within a few years.

Hundreds of supporters of the ballot measure, meanwhile, have showed up in Salt Lake City to protest.

“What’s going on right now in the Legislature is appalling,” said Paul Gibbs, a filmmaker who volunteered on the campaign to pass Proposition 3, the Medicaid expansion. Noting that many Republican legislators had opposed the Medicaid expansion enabled by Obamacare, he said, “They lost
fair and square and now they’re trying to undermine it any way they can.”

Sen. Allen Christensen, sponsor of the Senate bill, said voters “didn’t fill in the proper blanks” when they passed Proposition 3. “We’re filling in those blanks for them,” he said. “They are not obligated to balance the budget. We are.”

Approved by 53% of Utah voters in November, Proposition 3 had Utah join 35 other states that have expanded Medicaid or are doing so in 2019 with partial federal funding under the Affordable Care Act.

The Utah measure would expand Medicaid to cover people with incomes up to 138% of the poverty level, which is around $17,000 for a single person.

Approximately 150,000 Utahns were expected to enroll by April 1, according to official estimates. A sales-tax increase approved as part of the ballot measure would fund the expansion.

But the tax wouldn’t cover the entire cost of the program after two years, according to James Dunnigan, a Republican sponsor of the replacement bill in the Utah House.

To make up the shortfall, the Senate bill would only cover people with incomes up to 100% of the poverty level, a smaller expansion from prior law. In addition, total enrollment would be capped and those in the program would have to meet a work requirement.

The Senate bill also calls for Utah to apply for a waiver asking the federal government to bear a higher portion of Medicaid costs. The expansion would be canceled entirely if the waiver—which no other state has received to date—weren’t granted.

Legislators said they expected the state House to pass a version of the Medicaid bill. Republican Gov. Gary Herbert has supported similar changes to Medicaid in the past. A spokesman for the governor declined to comment on the specifics of this bill.

Unlike in states such as California, where the wording of citizen-passed measures is difficult to overturn, Utah’s Legislature is able to alter voter propositions by a simple majority.

Ray Ward, a primary-care physician and GOP member of the state House who opposes the bill, said there was a risk voters would punish legislators, “especially if it’s perceived that this really isn’t an expansion” of Medicaid.

Utah isn’t the only red state where voters have approved Medicaid expansion at the ballot box. Idahoans did so in November—and the Republican Legislature there is also considering changes to limit the measure.

But in Utah, activists say it is becoming a pattern for the Legislature to overrule voters.

“This has big implications for Utahns’ perception of the democratic process,” said Chase Thomas, executive director of Alliance for a Better Utah, which advocates for transparency in state government. “If
lawmakers don’t listen on this issue, we’re going to make sure voters remember that in the next election.”

Mr. Christensen, who also voted to replace the medical marijuana ballot measure, said he was respecting the will of the voters, but doing so in a more fiscally responsible manner.

“Am I smarter than the voters?” he asked. “At least I read the bill.”

This article originally appeared in the Wall Street Journal. Read it in its entirety here.

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