Utah Capitol 29

Legislators say the state is on track to have the first of two required waivers from the Trump administration approved which will allow them to implement a scaled back Medicaid expansion plan at the beginning of next month.

Rep. Robert Spendlove, R-Sandy, says the state is “working closely with the Department of Health and Human Services” in order for the state to begin their Medicaid expansion program on April 1. 

Earlier this session lawmakers passed SB96 which overrode the voter-approved Prop. 3 with a more modest Medicaid expansion. Instead of the full expansion which was mandated under Prop. 3, if the waiver is granted, Utah will expand Medicaid to Utahns earning up to 100% of the federal poverty level. The state needs the waiver from the Trump administration to implement that expansion at the current 70/30 cost split with the federal government.

Spendlove tells UtahPolicy.com that they expect that first waiver to be granted to the state in short order. Spendlove has been central to this issue as he sponsored and passed a similar limited Medicaid expansion last year.

The second part of the Medicaid plan requires another waiver that will change the cost split with the feds to 90/10. Normally, that requires a state to fully expand Medicaid to poorer residents earning up to 138% of the poverty level. The second waiver gives the more beneficial cost sharing to the state without full expansion.

Utah is also asking it’s federal Medicaid contributions for newly eligible recipients to be limited to a fixed amount per person, which would help keep costs down on the federal level.

Spendlove said Wednesday evening state officials are preparing to release something to the public in the next few weeks that will begin the public comment and formal review of the second waiver request.

Spendlove says they are “very optimistic” they’ll get that second waiver granted sooner rather than later.

Lawmakers made a big financial gamble with the plan to replace Prop. 3. The limited program will initially cost the state more to cover fewer people than full expansion, but if the waiver is approved, the state could save hundreds of millions of dollars in the future.

If that second waiver is not granted by the Trump administration, the state will then default back to the voter-approved Prop. 3 and fully expand Medicaid under the Affordable Care Act.