House Republicans pitch Dems on alternative Medicaid bill, but it’s clear they have enough votes to pass without them

Utah Capitol 08

House Republican leaders pitched the latest plan for a scaled-back Medicaid expansion to House Democrats on Friday morning, but they made it clear they don’t need Democratic support to pass the proposal.

In an early morning meeting, House Majority Leader Francis Gibson, R-Mapleton, told the minority caucus he would appreciate their support for the bill scheduled to hit the floor later that morning.

“When this bill passes later today, I don’t expect any of you to vote for it, and that’s fine,” he said.

Republicans are pushing to pass the bill with a ⅔ majority in both houses for two important reasons. The first being the bill goes into effect immediately when Gov. Gary Herbert signs it, which he indicated on Thursday afternoon he would do. The second reason for a supermajority is to block a possible citizen referendum to overturn the bill at the ballot box.

Several House Republicans told on Friday morning they believe the needed 50 votes in the House are there as the fallback plan in the new bill has assuaged the concerns of several members of their caucus who were reluctant to vote in favor of the previous version.

“If you’re voting against this because your constituents want the healthcare in Prop. 3, go ahead. But this bill does address the main issue of the proposition, which is providing healthcare for everybody,” said Gibson.

The plan, presented to House Republicans during a closed caucus on Thursday afternoon, expands Medicaid coverage to Utahns earning up to 100% of the federal poverty level, leaving Utahns earning between 101-138% of poverty on the federal healthcare exchanges where they can get subsidies for private insurance. Prop. 3 fully expands Medicaid under the Affordable Care Act to that entire population.

The more limited expansion depends on a waiver from the Trump administration giving the state a favorable financial cost split with the federal government. Currently, the feds will cover 70 percent of the cost for the expansion to 100%, while Utah is on the hook for 30 percent. If the waiver comes through, that split goes to 90/10.

The fallback plan if lawmakers cannot get the waivers to fully expand Medicaid coverage, similar to what voters approved with Prop. 3.

Democrats pressed House Republicans as to why Prop. 3 was becoming a fallback position when voters approved the measure in November.

“Expanding coverage to the 138 percent level is not a mandatory Medicaid coverage. If we expand to that, it becomes mandatory. If we try to dial that back, we open ourselves to a lawsuit,” said Rep. Jim Dunnigan, R-Taylorsville. “We have ‘x’ amount of tax dollars. If we can use those to expand coverage to ⅔ of that population instead of all of them, that makes the program more sustainable.”

Overall, Democrats seemed appreciative that Republicans chose to explain the new plan to them, but some were irked that it happened after the negotiations were over.

“Why weren’t Democrats involved in this until 7:30 am on the day that the new bill is supposed to come to the House floor,” said House Minority Leader Brian King, D-Salt Lake City. “This is not a good process. If we want better laws, then voters have to stop putting supermajorities in place.”

Rep. Carol Spackman Moss, D-Salt Lake City, was blunter with her take on the meeting.

“They told us they hope we’ll go along with this plan, but they don’t need us,” she said.

The bill is expected to pass the House on Friday, with the Senate approving the changes early next week.