SALT LAKE CITY (AP) — Utah Gov. Gary Herbert is still waiting to decide whether to accept the federal government’s offer to expand Medicaid, but a group of Utah lawmakers wants to let him know where they stand by passing a law prohibiting the expansion.
Republican lawmakers say the expansion offers a “false promise” of federal support.
Critics say the move is short-sighted and ignoring a detailed study of what’s in the best interest for the state.
Under the Patient Protection and Affordable Care Act (PPACA), the federal government has offered to pick up the full cost of Medicaid expansion in the first three years, and 90 percent over the long haul.
To date, 21 states plus the District of Columbia have announced plans to expand their Medicaid program. Fourteen states have opted not to expand while the rest, including Utah, have not made a decision.
If Herbert decided to expand Utah’s program, about 130,000 uninsured people would gain coverage under Medicaid. That’s in addition to the 225,000 to 250,000 people that are currently estimated to be the program in the state.
Some of the indecision in Utah and other states about expanding stems from concerns that deficit-burdened Washington may renege on the 90 percent deal. The regular Medicaid match rate is closer to 50 percent, which would mean a significant burden of the costs would shift to the states.
The federal government’s spending is “just not sustainable” and Utah cannot rely on federal dollars that may not be there for years to come, said Rep. Jacob Anderegg, R-Lehi, who sponsored the legislation forbidding the expansion.
If the state opts to grow its program, it will be forced to make tough spending choices down the road, Rep. Dana Layton, R-Orem, said during a news conference Friday.
“While there might be a short-term gain for our citizens, in the end it will be a recipe for disaster,” Layton said.
Medicaid expansion would not cost the state anything in the first three years thanks to the federal reimbursement, but by 2021, it would cost the state an estimated $60 million, shows projections from the Utah office of the legislative fiscal analyst.
Whether or not the Legislature approves Anderegg’s prohibition, lawmakers and the governor will be debating the issue over the next few months, House Speaker Rebecca Lockhart said Thursday.
Lockhart, a Provo Republican, opposes the expansion but said she hasn’t decided if she’ll support the bill.
On Thursday, the governor said he isn’t sure the legislation will make it to his desk, and he still plans to postpone his decision on the program until sometime this summer.
Herbert said he is awaiting the results of an outside study on the expansion’s effect on Utah.
There’s no timeline for the study’s completion and no federal deadline for Herbert to make a decision.
Proponents of expanding Medicaid say Anderegg’s bill would tie the state’s hands before the detailed analysis is available.
“This undermines the thoughtful deliberation and study that governor already paid for,” said Judi Hilman, executive director of the Utah Health Policy Project. “This is not a decision that should be decided by politics or philosophy about the size of government.”
Utah Democratic Party Executive Director Matt Lyon said the expansion will keep more tax dollars in Utah and alleviate some costs that the state is already paying.
“If we refuse the expansion, we will be on the hook for the hospital bills that the uninsured can’t pay, and the money that Utahans paid into the system through our taxes will go to cover the Medicaid expansion in other states that did opt-in, like New Jersey and Arizona,” he said in a statement issued Thursday.
Lyon called the legislation “a partisan hack job and ideological chest-thumping.”
Lyon and other critics accuse Republicans of rushing the legislation through the process at the last minute. It appeared late Wednesday when lawmakers substituted it for a bill that originally sought to nullify the federal health care law in Utah.
Anderegg said he and fellow lawmakers altered the bill because a review by legislative attorneys stated the nullification would not likely hold up in court.
The House is expected to vote on the legislation this week. Anderegg and his supporters hope it to have it approved by the Senate and head to the governor’s desk before the legislative session ends Thursday.