House Republicans are Between a Rock and a Hard Place on Medicaid Expansion

Here’s the political issue for House Republicans who oppose Healthy Utah:

 
If they adopt a hybrid — two years of Healthy Utah to get the 90 percent federal match, then switch over to Utah Cares and the 70-30 match — then they will just have to fight the Healthy Utah battle in two years, or maybe in the 2016 Legislature in an election year.
 
Why?
 
Because Herbert and his powerful Healthy Utah allies are not just going to stop. Herbert can’t, since he’s facing re-election in 2016.
 
So, what do the House Republicans gain by adopting a hybrid that is two years of Healthy Utah then Utah Cares?
 
Not anything.
 
And what do Healthy Utah advocates gain by agreeing to the hybrid, Healthy Utah for two years and then Utah Cares?
 
Well, they get Healthy Utah for two years and the 90 percent federal match.
 
And they get to fight again another day for extending Healthy Utah beyond two years.
 
The other risk factor is what happens if leaders of the LDS Church take a stand on Healthy Utah. We’ve seen the impact of church leaders on a controversial subject — the gay anti-discrimination/religious freedom bill.
 
If church leaders, for whatever reason, decide to go with Healthy Utah (and there are some fiscal reasons for them to do so — mainly not having to worry about poorer LDS members getting bad health care under Utah Cares), then that is a game changer for House Republicans.
 
Finally, after two years of Healthy Utah, then the switch to Utah Cares, a lot of poorer Utahns would find themselves pushed into the Primary Care Network. But PCN was never intended to be a broad-based medical insurance program, because it DOES NOT cover specialists and doesn’t cover hospital stays — what can be the most costly parts of health insurance.
 
House Republicans are faced with some tough political choices — go with the hybrid and fight Healthy Utah/Utah Cares for the next two years, do nothing and face that criticism as well.