Limited Medicaid Expansion Bill Meets Approval In First Senate Vote

Feb 1, 2019

Credit KPCW Radio

By the third day of the 45-day legislative session, a bill to amend Medicaid as outlined by Proposition 3 is already making its way through the chambers of government. KPCW’s Emily Means has more.

Utah state senators voted almost completely along party lines on the Senate floor Wednesday to advance a proposal adding enrollment caps and a work “effort” to Medicaid, with Woods Cross Republican Sen. Todd Weiler joining Democrats in voting against the measure.

Senate Bill 96, sponsored by District 19 Sen. Allen Christensen, was first debated Tuesday in the Senate Health and Human Services Committee, chaired by District 26 Sen. Ron Winterton. After more than an hour of questions from the committee and comments from the public, SB 96 passed out on a 6-2 vote, with Democrats voting against.

If approved by Gov. Gary Herbert, SB 96 would partially expand Medicaid to individuals up to 100% of the poverty level, as opposed to 138% through Prop 3. That would place people between 100 and 138% on the health insurance marketplace, potentially reducing costs for the state.

At the outset, Utah would pay 30% of the costs, while the federal government pays 70%, in the hopes that the federal government will eventually pick up the 90% outlined in Prop 3. Because the bill differs from Medicaid under the Affordable Care Act, Utah would require waiver approval from the Centers for Medicare and Medicaid Services, or CMS, the federal agency that processes Medicaid requests by states. Christensen says he’s received verbal assurance from CMS that such a waiver would be approved, though the timeline for that isn’t clear.

“When we get a waiver in the future, and we are told that we will—with new changes in administration and new changes in what we’re willing to give up—we are told that we can expect to get a 90-10 percent match before the end of this year and possibly within just a couple of months.”

During Wednesday’s Senate floor debate, lawmakers went back and forth on the numbers. Sen. Jake Anderegg, a Republican from Lehi whose Medicaid repeal bill hasn’t yet been heard at committee, says fully implementing Medicaid would cost $400 million in the first four years and that the state will have to make up an extra $310 million, though Christensen has said that legislative analysts informed him the state will be short only $45 million by 2023. As well as balancing the budget, Anderegg says full Medicaid expansion sends a message about hard work and wealth in the U.S.

“When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that, my dear friends, is about the end of any nation," Anderegg said. "You cannot multiply wealth in this country by dividing it.”

Sen. Gene Davis, a Democrat from Salt Lake City who has run full Medicaid expansion legislation in years past, explained his vote against the measure.

"We have a problem in this state," Davis said. "We have no problem giving money to the rich. We have no problem giving money to corporations to help them out, to help them grow. But we can’t find the dollars in this state to be able to provide health care to the working poor. I vote no.

SB 96 has another vote scheduled in the full Senate, as it awaits a fiscal note, before moving on to the House for discussion. Senators Curt Bramble, David Hinkins, Ron Winterton and Allen Christensen, representing portions of Summit or Wasatch Counties, voted in support of the bill.