Utah Not a ‘Donor State’ Under Obamacare

Utah State CapitolWhile Utah’s Medicaid expansion debate – which has dominated the last three legislative sessions – may be over with for a while, state House Republicans were told Wednesday that GOP Gov. Gary Herbert’s argument that Utah was losing hundreds of millions of federal dollars just doesn’t ring true.

One of Herbert’s most effective arguments for his Healthy Utah Medicaid expansion plan was that Utah’s were paying hundreds of millions of dollars in Affordable Care Act new taxes, but getting back little if Republican House members didn’t accept Herbert’s Healthy Utah.

However, the Legislature’s own budget office has compiled updated Medicaid expansion estimates.

House Majority Leader Jim Dunnigan, R-Taylorsville, who led the House’s Medicaid expansion efforts, told an open GOP caucus Wednesday that the new figures show that his HB437 of a year ago really is the best bang for the federal buck.

In short – and how can one really explain Medicaid expansion in any abbreviated version – Dunnigan said Herbert’s claim (he didn’t mention the governor by name) that Healthy Utah would reclaim $900 million dollars Utahns have paid into the new system doesn’t bear out in the new numbers.

Yes, said Dunnigan, Utahns have paid $970 million in new Obamacare Medicaid expansion, but over the same time Utah has gotten back more than $1.2 billion through various new health insurance programs.

Much of that $1.2 billion is coming back by 40,000 Utahns now participating in the health insurance marketplace programs of Obamacare, said Dunnigan.

Those numbers certainly are encouraging from the House Republicans’ point of view. You may recall that two sessions ago the Senate approved Herbert’s Healthy Utah plan, but House Republicans refused to go along.

Then last session, Herbert, senators and House members passed Dunnigan’s much-scaled-down HB437, which covers fewer needy Utahns.

In fact, material passed out at the House caucus Wednesday shows that Healthy Utah would have covered 155,000 poor Utahns while HB437 covers around 60,500, leaving 94,500 out of Medicaid expansion.

However, from that 94,500, Dunnigan said, around 28,000 could have been covered under current Medicaid guidelines; they just haven’t signed up.

Another 10 percent of that 94,500 may be covered by other health insurance —  like a spouse’s employment.

Said House Speaker Greg Hughes, R-Draper: “We are not a donor state” under Obamacare.

The new study shows “we are receiving all those tax dollars back, and then some,” Hughes added.

Who knows what will happen to Obamacare and Medicaid expansion now with Donald Trump winning the presidency.

Under HB437 Utah still needs at least one waiver from the federal Department of Health and Human Services.

And as of Election Day morning, Dunnigan said he spoke with federal officials who said they believed Utah could get the waiver. But the election may change many things.

If the waiver comes soon, HB437 can take effect April 1, 2017. If not, then it may be some time before Medicaid expansion shakes out in Utah.