Medicaid Expansion May Have to Wait Until 2016 Session

A new economic study comparing Gov. Gary Herbert’s Healthy Utah Medicaid expansion – Healthy Utah — and the GOP Utah House’s plan called Utah Cares finds Healthy Utah provides six times the financial benefits.

But the House’s expert on Medicaid expansion — Majority Leader Jim Dunnigan, R-Taylorsville – says the report is already outdated, biased and worth little in the current Medicaid expansion debate.

The Gang of Six – six GOP leaders Herbert rounded up after his Healthy Utah failed in the 2015 Legislature to find a Medicaid expansion compromise – has “already move beyond” Healthy Utah and Utah Cares, Dunnigan told a press conference he called to respond to the Healthy Utah advocates’ press conference earlier Tuesday.

Dunnigan would only show shadows of the “concepts” the Gang of Six is working on, adding that while he hopes and believes a special legislative session on Medicaid expansion could be called by Herbert later this year, it’s possible the Six’s compromise won’t be ready for legislative debate until the 2016 general session, which starts in January.

You can read the new report – put together for Utah AARP, the Utah Health Policy Project and Voices for Utah Children – here

Sven Wilson, the lead economist on the report, said: “In a nutshell, Healthy Utah provides six times the benefits that Utah Cares would.”

The financial returns: 24:4 for Healthy Utah, 4.1 for Utah Cares, bringing in hundreds of millions of dollars extra for the state.

It has been said, and the new report emphasizes, it’s a no-brainer for the benefit of Utah taxpayers – not to mention getting 66,000 low-income people health insurance – that Healthy Utah should be adopted post haste, says Wilson.

In fact, says Wilson, House GOP leaders (Dunnigan et al.) are just afraid that Healthy Utah will be a success – and then they will look bad for opposing it.

Dunnigan laughed at that idea: That House Republicans are afraid of the success of Healthy Utah and Obamacare’s requirements to help poorer Americans buy subsidized health care.

“That is so far away from the truth,” said Dunnigan, “that it’s not even worthy of a response.”

“I’m after good policy, trying to remove politics from this. That is silly” to say House Republicans are afraid of the possible success of Healthy Utah.

“We are not afraid of success,” said Dunnigan.

In fact, the House’s reluctance to adopt Healthy Utah – with no guarantees of financial or healthcare success – is an attempt to find something else that would be a success, not giving in to chance, he said earlier in his press briefing.

UtahPolicy reported several weeks ago that House Speaker Greg Hughes, R-Draper, (who was not available Tuesday) is trying to find a solution within the Gang of Six whereby health providers in Utah make significant financial commitments to help the state pay for Medicaid expansion.

Even better, says Hughes, would be the state turning over it’s cost-matching – 10 percent – to private healthcare providers, especially hospitals, and let them take the fed’s 90 percent in matching funds and run the whole program.

“Just get us out of it,” Hughes said referring to the state. “I’d take that.”

Dunnigan confirmed Tuesday that the Gang of Six was talking to local health care providers about giving money toward Medicaid expansion.

“We’d like broad-based (financial) participation by providers,” said Dunnigan.

It’s unclear, said Dunnigan, how much hospitals, doctors, and other medical care providers would make via Medicaid expansion in Utah.

“I don’t know. I asked them that,” but didn’t get an answer, said Dunnigan.

Certainly, he said, medical providers “uncompensated care” – costs billed to patients that are never paid – would decrease because low-income folks would be paying their medical bills under Medicaid expansion.

“Their uncompensated care would decrease, and that would help their bottom line,” said Dunnigan.

And here’s an interesting political twist:

— Wilson said that Utah Cares would only pay for primary care, not hospital stays or specialty care.

“Only 6 percent of medical costs are primary care,” he added.

That means 94 percent of a patient’s care costs come from hospitals and such.

And in dealing with the Utah Hospital Association – and trying to get them to pay for some of the state’s Medicaid expansion costs – the Gang of Six is dealing with former Lt. Gov. Greg Bell, the new president of the UHA.

Bell resigned his post – he was chosen by Herbert to be his LG several years ago – last year so he could earn some more money in the private sector.

And now Herbert, Dunnigan, and the rest of the Six, are trying to get Bell and his association to pick up some of Medicaid expansion’s costs.

Ain’t Utah politics interesting.

While the new Healthy Utah comparisons with Utah Cares may be interesting to some, said Dunnigan, they don't enter into the future legislative debate.

“It’s outdated already,” said Dunnigan. “I hope they didn’t pay too much for it.”

“We’re moving beyond” comparisons between Healthy Utah and Utah Cares.

The Gang of Six’s recommendation will be something else, Dunnigan said.