With U.S. House Speaker Paul Ryan saying Obamacare is with us for the foreseeable future, is it time for Utah to reconsider its torrid path to Medicaid expansion under the Affordable Care Act?
Not at this time, says Utah Senate President Wayne Niederhauser.
Utah’s political history with Medicaid expansion is a winding road – and a real political battle on Utah’s Capitol Hill.
For now, the state still awaits waivers on a whittled-down plan that would provide health insurance for 11,000 to 16,000 low-income Utahns. (That number has since been downsized by state health officials to between 9,000 and 11,000.)
A far cry from the more than 126,000 that would have been covered under GOP Gov. Gary Herbert’s Healthy Utah.
HU, as you may recall, passed the state Senate several years ago – put over the top by a few Democratic votes.
But it died in the House – as conservative representatives said it was too expensive and state government couldn’t afford to pick up the cost should federal officials not fund expansion.
At the time, Herbert said HU was still the best alternative for the least cost.
A year later, House Republicans put forward their scaled-back alternative – and it passed the Legislature and was signed by Herbert.
But the governor again said HU should be reconsidered if the legislators’ plan wouldn’t work out.
Well, the Obama administration refused to give the waivers. And so far the Trump administration has not indicated that it will, either.
So Utah is one of a dozen GOP-controlled states that have not expanded Medicaid, and have not collected hundreds of millions of dollars in federal matching funds to help poorer Utahns.
But, Gov. Gary Herbert thinks that there may be more flexibility for states under the Trump administration. He visited Washington, D.C. on Monday and said he talked with Vice President Mike Pence about how to move forward now that the effort to repeal Obamacare has imploded.
"There may be a willingness to give waivers that the previous administration was not," said Herbert during a conference call with reporters. "I think there's a willingness to find compromise. The president is reaching out to Democrats because the current system is not sustainable."
Herbert also says he's had more discussion during the first three months of the Trump White House than during the entirety of the Obama administration.
"I've been involved for 7 1/2 years. We've been invited to give more input now than in the last 8 years combined. It's refreshing that those who are on the front lines have been invited to the table."
Niederhauser, R-Sandy, told UtahPolicy on Monday that now is not the time to changed Medicaid expansion horses.
“The risks are still out there” under any kind of Obamacare Medicaid expansion, said the president.
He refers to uncertainty that the federal government will continue providing a huge match to state expansion dollars – starting at a 90-10 match and going down to a 70-30 match over time.
“There remains political uncertainty” over Obamacare and what the Trump administration will do in terms of waivers, funding, local exchanges and more.
“Now is not the right time” to revisit either full expansion, Healthy Utah, nor even the Legislature’s plan passed a year ago.
Niederhauser said he hopes the Republican-controlled U.S. House and Trump will continue working on Obamacare repeal and replacement.
But Trump and Ryan say that is not their plan. They will move on to personal and corporate income tax reform.
Trump says Obamacare will collapse on its own; with the questions remaining whether he will help its downfall via presidential orders, funding and such.