The fight over Medicaid expansion is underway on Utah's Capitol Hill.
On Friday, Sen. Brian Shiozawa, R-Salt Lake City, officially put Gov. Gary Herbert's Healthy Utah plan in play with SB 164, which is essentially the same thing as Herbert's proposal which uses federal money to help needy Utahns get private health insurance.
"One of the things I’ve learned is how well made this plan is given the circumstances in which we find ourselves," says Shiozawa. "The more people understand this, they will embrace it. It covers more people at a lower cost. You show me something better."
Shiozawa, a doctor, says he has first-hand experience with how devastating lack of health insurance can be.
"I treat these patients every day, so I see the implications of not having health insurance on their lives. I also see how it costs them money and I apprecate how much it costs the state of Utah. As people see this from a pragmatic and humanitarian standpoint, it is by-far the best plan."
New consensus numbers on the Healthy Utah plan estimate 136,000 Utahns would be covered by fiscal year 2019. The cost to the state would be $236.7 million over 6 years. That investment would bring more than $3.2 billion in federal money back to the state during the same time period.
Gov. Herbert says he's confident the Legislature will eventually come around to his way of thinking.
"That money will be invested right back into our economy," says Herbert. "I think as the Legislature has the opportunity to understand all the ramifications, there's only so many things you can do that make sense."
An alternative plan on the table is SB 153 from Sen. Allen Christensen, R-North Ogden. He is proposing a much more modest expansion of Medicaid that would extend coverage to about 9,000 Utahns who are considered to be "medically frail."
Christensen says he objects to Herbert's Healthy Utah because of the pricetag and the expansion of federal power.
"I'm philosophically opposed to putting more people unde government control and giving them healthcare is government control, like it or not," he says. "Gov. Herbert has already opened every drawer and swept the corners to find every dollar he can. If we do that, there will be none left for other needs."
The consensus numbers from Herbert's office says Christensen's plan would cover about 16,000 Utahns over a six-year period at a cost to the state of $200 million. That money would bring back $611 million in federal funds.
Herbert says, when you compare the two plans, his makce much more fiscal sense.
"The two have essentially the same cost, but one program gets us $611 million and the other brings $32. billion. Which one is best to you?"
For his part, Christensen isn't buying that rationale.
"We turned down more than that on federal education programs. With No Child Left Behind, the feds offered us tremendous amounts of money and we turned it down. If we take the bait here, it could be disastrous. Because of the strings attached to this money, I just can't sign off on this."
Shiozawa says he thinks the opposition to Healthy Utah runs a little deper than that.
"There may be some ideological problem with embracing anything that has to do with Obamacare or the Affordable Care Act. Let's get this money and use it for ourselves. There will be strong emotions in this debate. I would hope we could look at this and decide what's going to be best for Utah."
Christensen says the supporters of Healthy Utah have pulled out all of the stops, noting it's one of the best campaigns he's ever seen. Does he expect Gov. Herbert to put more pressure on lawmakers to approve Healthy Utah?
"I do not. I think he's already brought as much heat as he knows how to provide there."