Herbert says he’s ‘cautiously optimistic’ the feds will approve Utah’s alternative Medicaid expansion plan

20190224 Herbert CSPAN

Gov. Gary Herbert says he’s “cautiously optimistic” that the Trump administration will give Utah the waivers they need in order to implement the scaled-back Medicaid plan passed by lawmakers during the 2019 session.

Herbert was a guest at the Politico State Solutions Conference on Friday where he was asked who in the federal government has encouraged the state to apply for the waivers that allow the state to expand Medicaid to fewer people than the Affordable Care Act while still enjoying a more favorable cost split. Herbert was noncommittal on his answer.

“We are looking at the department of health. We have been working with them for a long period of time,” he said. 

Politico reported Friday that Utah’s Department of Health began working to supplant the voter-approved Medicaid expansion within a few days of the November election, pressuring federal Medicaid authorities to approve a more limited expansion.

Herbert says he’s also had discussions with Vice President Mike Pence about Utah’s proposal, which he said will allow states to craft their own healthcare solutions.

“I’m cautiously optimistic that this is going to be a proposal that they are going to want to embrace, which I think is going to be a model for the country,” he said.


SB96 replaces the Prop. 3 full Medicaid expansion, which voters approved this November. Under the alternative plan, Utah will expand Medicaid to poor Utahns earning up to 100% of the federal poverty level if the Trump administration gives the state a waiver to do so. If approved, Utah will only pay 90% of the cost of the expansion. Under the Affordable Care Act, the 90/10 split is usually only available to a state if they expand coverage to residents earning up to 138% of poverty.

Utah’s alternate plan will cover about 60,000 fewer people than the full expansion.