On Nov. 6, Utah voters passed Proposition 3 and finally put to rest a years-long debate.
Citizens of our great state chose to fully expand the Medicaid program as directed under the law, to 150,000 people in need, without relying on complicated waiver approval from the Trump administration. Now, Medicaid expansion must be implemented, with enrollment beginning on April 1st, as the people decided. Vulnerable Utahns cannot wait another day to get the care they need. For some individuals, this is the help they have been waiting for so they can get healthy and back to work. For others, this is the key to finally access lifesaving medical treatment before it’s too late. Many have already scheduled appointments for April.
Yet, an effort to repeal the expansion under Proposition 3 is currently being considered by members of the Utah legislature in SB96. They claim the ballot initiative to expand Medicaid, now Utah state law, must be repealed and replaced with their plan, which would very likely indefinitely delay access to care—costing Utahns more money to cover fewer people.
To be clear, Proposition 3 does not need any action by the legislature to fix it. It can be implemented on April 1, 2019 as is. Even those who are worried about the impact on the state budget say we have at least two years before the plan might run into the red. The most prudent path is not rushing into ill-thought legislation. Legislators should pause and see what happens first. There is no immediate fire to put out. The voters decided; let’s give their plan a chance to work before we repeal it.
Any delay or significant change to Proposition 3 is a repeal of the will of the people. Calling legislative actions “fixes”, “adjustments”, or “amendments” may soften the language around repeal, but it won’t soften the harmful impact.
For legislators truly concerned about cost, we can address financial issues head-on, without risking care. SB96 goes well beyond fiscal solutions, asking for things that multiple administrations—including the Trump administration—haven’t allowed. This puts federal approval and the fate of Medicaid expansion in jeopardy. The bridge plan being considered, to extend coverage to those in the gap from 0-100% Federal Poverty Level until a waiver is approved, costs the state 3 times more than Proposition 3. But maybe the worst thing about SB96 is that it has no backup plan. No good plan does not have a backup plan. Under SB96, if we don’t get federal approval, we are back to square one—no expansion and thousands of people without access to care.
There are very straightforward ways to move toward long-term fiscal sustainability without undermining the spirit and intent of what voters decided in Proposition 3—and without federal waiver approval. For example, a recent fiscal note from HB210 (sponsored by Representative Ray Ward, R- Bountiful) shows that eliminating a steep increase in provider rates and collecting a hospital assessment would do the trick—extending the Medicaid expansion program’s solvency for years.
Most of us wouldn’t risk 10 dollars on a bet attempting to predict the federal government. So why are lawmakers, in pursuing federal waiver approval, willing to gamble with the lives of our neighbors, friends and family? These hard-working people in the coverage gap have been waiting without access to health care for too long. It is time to move forward without delay. Without adding red tape. Without threatening coverage with caps and cuts. It is time for full Medicaid expansion—on April 1, as Utah Decided.
