House Working on Compromise Proposal for Medicaid Expansion

Gov. Gary Herbert’s Healthy Utah may be dead in the Utah House, but now there’s a new compromise in the works.

House Majority Leader Jim Dunnigan told a gaggle of journalists Friday afternoon that he has a plan “that will work” while, for just two years, cover 60,000 Utahns who are “in the gap” for around $65 million in total dollars.

Dunnigan, R-Taylorsville, didn’t really want to talk about it, as he still has to have more discussions with GOP senators, Herbert, and his own caucus.

Still, pressed by reporters, he gave up a bit:

— The neediest of Utahns, those that are between 0 percent and 100 percent of the federal poverty line, would get coverage for the next two years.

— Come January 2017, when a new U.S. president takes office – whether a Democrat or Republican – Utah would push hard (and perhaps with other states onboard) to get the 90 percent federal dollars for Medicaid expansion as ordered by the Affordable Care Act, or Obamacare.

The Obama administration has been dead-set against allowing any state which stays at 100 percent of poverty or below to get that 90 percent federal match.

Federal Health and Human Services officials say if a state stays under 100 percent of poverty, they get only a 70 percent federal match – and have to pick up 30 percent with state dollars.

Herbert’s Healthy Utah goes up to 138 percent – where Obamacare wants Medicaid expansion to be.

So, Healthy Utah covers more people and costs less than any plan under 100 percent of poverty – something the governor has been arguing for, and something that has forced any House GOP plan UNDER 100 percent to bear more state dollars.

But Dunnigan, who has worked on this issue for years, said his compromise will cost less than Healthy Utah and – with a reasonable new federal administration – will provide a pathway to help Utah’s poorest, sickest Utahns while remaining “sustainable.”

That’s been the key word for House Republicans – “sustainable” — they don’t want the federal match to drop, don’t want to see the state’s Medicaid expansion costs to skyrocket.

That, House Speaker Greg Hughes reiterated Friday afternoon, is just unacceptable, and would be irresponsible to treat all Utahns to that result.

The Senate this past week passed SB164, Herbert’s Healthy Utah plan.

But the GOP House caucus, says Hughes, doesn’t even come close to having the 38 votes needed to pass it.

So Hughes has said SB164, or Healthy Utah, won’t come out of the House Rules Committee, and won’t be heard – mainly because it would be a waste of valuable, and limited, time.

Hughes has been taking a lot of public and private political heat for that decision.

But now Dunnigan says there may be a compromise House Republicans may accept – although that is yet to be decided within the 63-member caucus.

His idea “would fund all the people in the gap” – the 0 percent to 100 percent of poverty who don’t have health insurance or Medicaid now.

“It would be sustainable” at $65 million in total cost over the next two years, he added.

Then, in January 2017 Utah can go to the new president and ask to allow the state to have 90 percent of the federal match.

“That would be wonderful,” he added.

Even if the new president would agree, then Dunnigan’s plan would still be controllable – either by placing a cap on the financial cost, capping the number of people on the plan, or a combination of both.

Or, a future Legislature could decide to put more money in the that plan to fully, or partly, let the program costs and the number of recipients grow.

In the meantime, said Dunnigan, Utah would be helping the poorer, sicker among us, “and solve a problem” forced on Utah and other states with the Obamacare Medicaid expansion.

More details of his compromise will come early next week, Dunnigan said.