Herbert ‘Not There Yet’ on Compromise Over Healthy Utah

Rumors that GOP Gov. Gary Herbert has agreed to a Healthy Utah compromise seem to be a bit premature, as Herbert strongly defended his Medicaid expansion plan Tuesday afternoon and said it is far superior to a brand new idea put forward by House Majority Leader Jim Dunnigan, R-Taylorsville.

Dunnigan’s HB446, introduced Tuesday, which is being called Utah Cares, and SB164by Sen. Brian Shiozawa, R-Cottonwood Heights, which is Healthy Utah, will together be sent to a House standing committee for a hearing and possible amendments.

That’s a small win for Healthy Utah – for days House GOP leaders have been pounded for refusing to even hear SB164.

Herbert listed any number of reasons why Healthy Utah is so much better than HB446, although he is “intrigued” by the idea floated that the two bills can be combined in some way.

But he’s not there yet.

The idea is that Healthy Utah can be adopted for two years – one way to get the fed’s 90 percent Medicaid expansion match – then it would be dumped and HB466 would take over, with a smaller number of Utahns being given health care insurance.

HB466 would get only a 70 percent federal match – but that is about what would be coming from Healthy Utah after two years anyway.

Still, as one legislator told UtahPolicy on Tuesday – by combining HU with Utah Cares would be playing the feds for chumps: Get the 90 percent fed match for two years, and cover 126,000 Utahns, then dump HU and lower the number of Utahns who would be covered and still get the 70 percent federal match.

But in a later press conference House Speaker Greg Hughes, R-Draper, (who is having a hard time sitting after the public butt-kicking he’s taken in recent days) and Dunnigan said Healthy Utah is just not sustainable.

And Utah Cares is, “while a more modest program,” a lot better than making tens of thousands of poor Utahns sign a waiver saying they understand they can lose their health care insurance after two years, and the Legislature finds it can no longer pay for Healthy Utah’s growing cost.

In any case, Healthy Utah will get to be debated by a House committee (and perhaps there combined with HB446).

Herbert said he is not in favor of adopting HB466 for the first two years, and then adopting Healthy Utah from then on.

That, he said, would leave many poorer Utahns not getting proper health care insurance for at least two years, and leaving a bunch of federal match money on the table.

But going with Healthy Utah for two years, then dumping it and going with Utah Cares?

That remains to be seen – at least that was Herbert’s message to the press on Tuesday.

One criticism, the governor said, is that folks are not comparing “apples to apples” – as his aides passed out one sheet comparing Healthy Utah to Utah Cares.

In his press conference, Hughes’ aides passed out a different sheet showing different numbers.

Both sides have reasons why their numbers don’t match up. But when you leave it to journalists to do math – well, that’s never a good solution.

In any case, Herbert said Healthy Utah captures more federal funds – taxes Utahns have paid anyway — for longer, and provides much better health care for poorer Utahns than any other option out there, including Utah Cares or some kind of “compromise” between HU and Utah Cares.

But Hughes said those above 100 percent of the federal poverty line that would be left out under Utah Cares would fall into the current Primary Care Network – because HB446 removes the PCN enrollment cap.

PCN is a federal program whose cost is picked up totally by the federal government, Dunnigan added.

Hughes then read off a long list of PCN coverage items, including birth control, and Dunnigan called PCN the “Cadillac” of government health care programs.

So, where are we in Medicaid expansion?

There are still seven days left in the 2015 Legislature – and no doubt more deals on Medicaid expansion may be coming.