Spendlove Proposes ‘Middle of the Road’ Medicaid Expansion

For several months the Medicaid expansion debate on Utah’s Capitol Hill has been between GOP Gov. Gary Herbert’s Healthy Utah and the “medically frail” alternative advocated by a number of legislative Republicans.

Now comes a “middle of the road” alternative, says Rep. Robert Spendlove, R-Sandy.

His HB307, introduced Wednesday, would cover poorer Utahns up to 100 percent of poverty, or about 60,000 people, Spendlove told UtahPolicy, and cost in 2021 between $40 million and $60 million (the fiscal note is still being prepared).

By comparison, Healthy Utah would cover Utahns up to 138 percent of the federal poverty line, cover up to 146,000 people at a 2021 cost of $77.8 million.

The “medically frail” plan favored by a number of legislative Republicans would cover a much smaller number, only those who are the most sick of the poor, or around 10,300 people and cost $28 million by 2021.

Besides splitting the two Medicaid expansion ideas now prominent on Capitol Hill, Spendlove says his would do something more:

Where Healthy Utah allocates state/federal funds to poorer Utahns so they can purchase private health care insurance, SB307 “makes the state much more active in deciding a quality health care plan” for each of the recipients.

That active support, says Spendlove, will make sure that poorer Utahns who qualify don’t waste money, nor would their personally chosen health care insurance not really fit their needs.

With state officials overseeing each recipient’s managed care, there would be more cost control and better care for each low-income person.

All this is still based, said Spendlove, on a 90-10 federal/state split.

This idea has already been looked at by other states, and could be ready to implement rather quickly, he added.

Under HB307 “we would have control of costs, quality of health care, and control access to the program – all things” that either Healthy Utah or the “medically frail” alternatives don’t fully achieve.

“I’m an idea guy,” said Spendlove, who has worked in the executive and legislative branches of government and said he’s been studying and working on Medicaid expansion for several years.

Why haven’t we heard more about his alternative sooner?

“I tend not to speak up much, until I know” which of his ideas he wants to push, said Spendlove.

As the Medicaid expansion debate now moves closer to the session’s front burner, he hopes that his colleagues will seriously consider HB307 as a compromise between the austere “medically frail” and the larger, more encompassing Healthy Utah.