Medicaid study group presents options to governor


Associated Press

Posted on September 26, 2013 at 5:04 PM

Updated Thursday, Sep 26 at 5:05 PM

SALT LAKE CITY (AP) — A state study group has laid out a handful of options for expanding Medicaid in Utah, though Gov. Gary Herbert is still holding off on a decision about expanding the program.

At the governor's annual health summit Thursday, Herbert reiterated that he has not yet made up his mind, but said he's getting closer.

"With so many lives affected, and so many taxpayer dollars at stake, I'd rather do this right than fast," Herbert said.

Herbert has previously said he may not decide until January.

Many of the options require federal approval, which could further delay a clear path to coverage for people who may be falling through the cracks.

As part of President Barack Obama's health care overhaul, states have the option of expanding Medicaid eligibility to people making up to 138 percent of the poverty level.

If states opt to expand, the federal government will pay the full cost through 2016 and 90 percent after that.

If Utah expands, about 123,000 uninsured people would gain coverage. That's in addition to the 225,000 to 250,000 people already on the program.

Herbert and other Republican leaders in Utah have been reluctant or resistant to take up the offer, citing concerns about the sticker price and whether federal budget strains may cause Washington not to hold up its side of the agreement.

Even if Utah doesn't expand Medicaid, there are mandatory changes under the health care law that will bring an additional 60,000 people into the program in Utah and drive up state costs by $213 million over the next 10 years, according to an outside analysis Utah has commissioned. The study also found that the mandatory changes will generate an additional $36 million in state and local sales taxes.

The Medicaid study group is made up of lawmakers, business leaders and community advocates. Besides exploring options about whether to fully expand Medicaid, the group examined partial expansions and pathways that use subsidies, grants or charity care programs.

The options present a jigsaw puzzle of financial, political, administrative and moral considerations.

For example, if the state offers all Medicaid benefits to everyone up to 138 percent of the poverty level, it would save more than $110 million in state and local safety net programs over the next 10 years, according to the report.

It would also generate an additional $200 million in state and local sales tax revenues, create more than 4,000 new jobs, and save hospitals and health centers more than $800 million they would otherwise spend to provide care to those who can't afford to pay.

But that same option would increase Utah's share of Medicaid costs by $260 million over the next decade, and it's unclear if doctors and center that provide care for Medicaid patients can handle a flood of new patients as thousands join the program.

Herbert said he's weighing the options, and it's possible Utah will pursue a mix of the options.

"When we make this decision, it will be well-thought out, all ramifications will be understood and it will include as many points of view as possible," Herbert said. "The good news is that we are getting close."


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