Bob Bernick’s Notebook: Has Medicaid Expansion Taken a Political Toll on Hughes?

bernick mugOn the Medicaid expansion front, some may say 2015 has not been a good year for Utah House Speaker Greg Hughes.

Inside the large 63-member House GOP caucus Hughes, R-Draper, won the speakership in an impressive fashion a year ago, following the 2014 elections.

And Hughes certainly took strong positions – Medicaid expansion just one of them – during his freshman session as speaker last January.

But with the complete failure of Utah Access Plus – the Gang of Six’s Medicaid expansion plan that exploded in defeat earlier this month, a plan Hughes backed with just six other House Republicans – UtahPolicy sought to test Hughes’ leadership support.

In an hour-long, wide-ranging interview with UtahPolicy this week, Hughes himself said it is an appropriate question to ask: Does he still have the support of his caucus considering Utah Access Plus’ overwhelming rejection?

“You should ask that question,” the speaker said.

He believes he does, explaining in depth how he went forward with Utah Access Plus, hoping – but understanding – that objections from Utah’s medical community could sink the proposal.

And those objections did.

Asked if he was going to run for a second, two-year term as speaker after the November 2016 legislative elections, Hughes said he was not backing away from any of the obligations he has now.

So expect Hughes to seek a second leadership term – which has pretty much been the case of recent speakers of the Utah House.

UtahPolicy spoke with half a dozen House Republicans seeking off-the-record comments on Hughes’ current standing within the caucus, and his prospects should he run for speaker again next November.

UtahPolicy tried to get a mix of responses, some from clear Hughes-backers, moderates and conservatives, and at least one member who did not vote for Hughes for speaker a year ago.

All said Hughes is not critically injured and would be the clear favorite for speaker next year.

But several said Hughes has some bridges to mend.

And that the 2016 Legislature is important for Hughes as a leader.

“I believe he needs to have a big win this (coming) session,” said one House GOP moderate.

Not necessarily on the Medicaid expansion front, this representative added.

Medicaid expansion may not even be accomplished this coming session – there are such divisions between House and Senate Republicans and GOP Gov. Gary Herbert.

But, this House Republican said, there are other areas where Hughes will have break-through opportunities.

One issue could be dealing with Utah’s homeless population, seen more and more in urban areas, especially Salt Lake City.

If he takes such issues on personally – “really leads out” – then a second term as speaker can be assured, this House Republican said.

Several said Hughes’ speaker re-election hinges on who may come out to challenge him.

Over the last two decades, a speaker’s first re-election has been kind of given – with only token opposition put forward by an intra-caucus challenger.

Hughes defeated a sitting House majority leader last year in the open speaker’s race by getting by far most of the “young” House members – those who had been in the House only one or two terms or were incoming freshmen.

Those “youngsters” will probably stay with Hughes, said one House veteran.

“They really like the way Greg is standing up, taking tough stands on many issues, out there in the public,” said one House Republican, who didn’t support Hughes a year ago.

Hughes has certainly earned the wrath of a few newspaper editorial boards and pro-Medicaid expansion groups over the last ten months.

In part that came when Hughes – at first – declared Herbert’s Healthy Utah Medicaid expansion bill would not get a hearing/vote in the 2015 House – for it didn’t have the support in the GOP House caucus.

Hughes later relented. The bill died in a House committee vote – but did get a full House vote when a Democrat tried to substitute the HU plan into a GOP House caucus expansion bill.

But Hughes took a lot of heat over that early no-vote decision.

And he took heat again when Utah Access Plus was discussed in a closed House caucus.

(The GOP-controlled Senate always holds closed caucuses; the House usually holds an open caucus. But when the House closes it caucuses the media jumps on that rarity, leading some House Republicans to tell UtahPolicy that the House should just close all their caucuses like the Senate does.)

Said another GOP House member: “Greg is an incredibly bright guy. But he does have some bridge-mending to do, I believe.”

The 2015-session stonewalling on giving Healthy Utah a hearing and vote on the floor, and demanding 38 votes out of the House GOP caucus to move forward on Utah Access Plus (it got just seven GOP votes) this fall is hurting the House’s standing among the public, this Republican says.

Individual House caucus members have to defend those actions by Hughes, in some cases.

And it is uncomfortable for some House Republicans.

But does all this add up to Hughes being vulnerable in leading in the upcoming 2016 Legislature – or even beyond in a contested speakership race next November?

Most likely not, said those UtahPolicy talked to.

Hughes, in explaining his approach to Medicaid expansion votes, harkens back to the very controversial public school voucher vote of 2007.

Then House GOP leadership pushed individual caucus members for a “yes” vote on the voucher bill – getting just the 38 needed for passage.

But, says Hughes, in the hallways after that arm-twisting some caucus members complained their committee chairmanships or other important assignments were threatened by leaders.

“I’m not saying that (threatening) even happened,” said Hughes. But members were defending their “yes” votes CLAIMED it happened, and they didn’t have a real choice.

It led to a split in the caucus, says Hughes.

And he wasn’t going to pressure anyone on Medicaid expansion votes – especially the Utah Access Plus vote, which took place in a closed House caucus earlier this month.

And Hughes didn’t pressure them, at all, the half dozen Republicans UtahPolicy talked to said.

“Did my caucus like my open approach” to Utah Access Plus? Asks Hughes.

Or did some caucus members think there was too great a vacuum of power – wanting to be led, even pushed?

“I thought this a better way to do it – especially after what I saw in the voucher vote.”

While there is political heat today over Medicaid expansion, it is nothing compared to the 2007 voucher fight or the earlier knockdown, drag-out battle between the banks and credit unions earlier in Hughes’ legislative tenure, the speaker said.

Hughes said there may be some caucus members who ask: “Why did Hughes put me through this” Gang of Six plan when it didn’t have a chance of passage?

But Hughes says he really did think Utah Access Plus had a chance – if only the health care community would agree to be assessed 7 cents on each $1 made through getting Obamacare expansion money.

In the end, he was wrong.

Every group, from hospitals to doctors – who had pushed for Healthy Utah expansion in the 2015 session – turned on expansion when asked to pay most of the state’s 10 percent match under Utah Access Plus.

“We learned this is one of those big emotional issues. We have to step forward and make a vote of conscience. I did the best I could to come up with a plan (Utah Access Plus) that addressed the issues put forward (in the 2015 Legislature).”

“I’m a big boy. I can take it” – the criticism aimed directly at him personally.

And Hughes said he won’t be backing away from any other upcoming fights. “That’s not me.”