Niederhauser Leaning Toward Supporting Healthy Utah

For the moment, GOP Gov. Gary Herbert has valuable ally in the Healthy Utah-Medicaid expansion legislative battle.

Senate President Wayne Niederhauser, R-Sandy, told UtahPolicy Monday that he wants to “fund the gap” in Medicaid expansion.

And the only plan that does that presently is Herbert’s Healthy Utah – reflected in a bill just introduced by Sen. Brian Shiozawa, R-Cottonwood Heights. That is SB164.

Niederhauser said that the Senate GOP caucus (which is always closed to the public and media) will discuss Medicaid expansion Tuesday.

“I’m willing to listen and be persuaded” that Healthy Utah/Shiozawa’s bill is not the way to go, said Niederhauser.

But, he added, he has been in close contact with House Majority Leader Jim Dunnigan, R-Taylorsville, over the last 18 months and believes he – Niederhauser – is well versed on the issue. Dunnigan is the House’s Medicaid expansion expert.

“The bill I liked the best is last years 70-30 plan,” said the Senate president.

But that bill has not been introduced this session, and may well not be since it didn’t have enough support a year ago.

That plan of a year ago “just cost the state so much money,” Niederhauser added.

That’s what Herbert has been arguing for six months or more – that his Healthy Utah plan covers the most lower-income Utahns and – with the federal government picking up 90 percent of the cost for the first couple of years – saves Utah taxpayers the most.

Meanwhile, House Speaker Greg Hughes, R-Draper, told UtahPolicy that the hard negotiations over Medicaid expansion “is sucking all the air” out of the Legislature’s work as the third week of the 2015 session begins.

Medicaid expansion must be solved as quickly as possible so other important budget matters and bills can get needed attention, said Hughes.

The Utah GOP caucus seems further away from Herbert’s Healthy Utah than does the Senate Republican caucus.

But more will be known after Tuesday’s GOP caucuses.

Here is a link to an Excel spreadsheet which Marty Carpenter, Herbert’s director of communications, says best explains the various alternatives now being discussed over Medicaid expansion – with down-the-road numbers on costs and benefits.

Under the title “Healthy Utah” on the spreadsheet is Herbert’s plan, which should cover 109,000 lower-income Utahns by fiscal year 2012 at a state cost of $50 million.

If a lot more lower-income Utahns “come out of the woodwork,” and seek coverage by 2021, then Healthy Utah could be covering 146,000 Utahns at an annual cost of $77 million.

The “medically frail” on the spreadsheet alternative is the plan many House Republicans are looking at.

That plan would cover only 8,300 of the sickest Utahns, at a cost of $2.9 million by 2021. If you include the “woodwork” folks – who upon learning of coverage would seek it – that plan would cover only 10,300 of the sickest Utahns by 2021 at a cost of $28 million.

However, Healthy Utah, through a complicated federal funding formula, would bring back more Obamacare tax dollars to Utah than would the “medically frail” plan House Republicans are considering.

And that cost, along with more Utahns being covered, is what tips the scale for Niederhauser.

Simply put, says Herbert, Healthy Utah is by far the best way to make lemonade out of the Obamacare lemons.

Niederhauser said at this point he has to agree, even though he is willing to discuss any alternatives – if they can be found.