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Utah Republicans Weigh Medicaid Expansion

By Rebecca Adams, CQ Roll Call

February 9, 2015 -- The Utah legislature will debate Medicaid expansion this week, days after the issue faltered in Wyoming.

A few states are weighing whether to broaden eligibility in Medicaid, the federal and state partnership for the poor. The health care law allows states to choose whether to enroll for people with income of up to 38 percent above the poverty level. The issue died in Tennessee last week after GOP Gov. Bill Haslam was unable to persuade other Republicans to expand coverage.

In Utah, a plan by Republican Gov. Gary Herbert is competing against a different, narrower proposal by other Republicans to expand benefits for people who are medically frail. On Tuesday, Utah Republican legislators will meet in a closed-door meeting before deciding how to proceed.

Late last week, Herbert was asked by local reporters about opposition to his plan among his fellow Republicans.

The governor said that under his plan, it would cost the state about $236 million total over six years to win $3.2 billion from the federal government in matching grants. The health law says that the federal government will pay all of the costs of the individuals who qualify under the expanded guidelines through 2016, and then phase down that amount until the federal government pays 90 percent of costs in 2020 and afterwards.

The other plan put forward by GOP legislators would cost about $200 million, according to Herbert, but the governor said it would only attract $611 million in federal financing. Herbert said that his plan would help more than 100,000 more people than the alternative proposal Republicans are considering.  

“I think the contrast is stark,” Herbert said, according to an audio recording of the press conference.

He added that the other GOP proposal is “better than nothing, but it's not a lot better."

The GOP governor sought to distance himself from the overall law and the Obama administration, noting that he had been among the governors who challenged the constitutionality of the law in 2012 before the Supreme Court upheld the fine for people who don’t get coverage but gave states more of an opportunity to reject the Medicaid expansion.

Herbert said that the state is contributing money for coverage in other states.

“Obama took it from us,” he said. “I want it back.”

In Wyoming, the debate over Medicaid collapsed late last week. Republican Gov. Matt Mead had pushed for a plan to expand coverage, and other Republicans had promoted an alternative plan that mirrors one that the federal government recently approved in Indiana.

But the state Senate voted down the plan, and the House Labor, Health, and Social Services Committee abandoned plans to consider legislation.

“While I respect different views, the fact is today we are left with working poor without coverage,” said Mead in a statement on Friday evening. “We are left with Wyoming taxpayer dollars funding health care of other states. We are left without a solution for $200 million of uncompensated care that our hospitals must absorb and pass on to the rest of our citizens and we are rejecting $120 million dollars meant for Wyoming.”

So far, 28 states and the District of Columbia have expanded Medicaid. Of those, 10 states were led by Republican governors.

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