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Three-hundred-and-sixty-one white wooden crosses were planted in the lawn of the Utah Capitol on Wednesday, representing the estimated number of people who have died because of the Legislature's failure to expand Medicaid, as advocates kept pressure on lawmakers to act.

"If Utah has any great leaders lurking in this swamp of ineffectiveness, here is what he, she or they should do: First seize the moment before the federal-incentive window slams shut," said David Irvine, a former Republican House member and board member of Alliance For a Better Utah, a progressive advocacy group. "Second, stop wasting everyone's time and flimflamming the public with a secret policymaking process."

He said the Legislature should find a broad-based funding mechanism and build a coalition to pass the bill.

Last week, Republican lawmakers killed Utah Access Plus, the latest attempt to use $450 million in federal Medicaid dollars to subsidize health insurance for 126,000 low-income Utahns. The proposal would have imposed about $50 million in taxes on doctors, hospitals, pharmaceutical companies and other health care providers in order to collect the state's share of the program.

But House Republican leaders said discussions on how to cover the poorest of the poor ­— those making less than 100 percent of the federal poverty level with a program using less federal money — will continue.

"We are not done talking about it, but I think we will find the solution for those in this coverage gap who do not have care," House Speaker Greg Hughes, R-Draper, told members of the House Republican caucus Wednesday. "I think we will have a Utah solution. If you put it next to a very rich and robust Medicaid program, it probably does suffer. … We've given it everything we've got."

Irvine said Utah has "turned its back on more than $700 million" each year in money citizens are paying in taxes that would cover the costs to expand Medicaid.

House Republicans were told Wednesday that isn't the case: Based on state figures, Utah has paid $710 million in taxes and received $730 million in insurance subsidies and assistance to insurance companies.

"If the question is: 'Could we get even more money back by chumming up state dollars and getting back federal dollars?'

The answer is: 'Yes, we could,' " said House Majority Leader Jim Dunnigan, R-Taylorsville.

Hughes also disputed news reports that he insisted on getting 38 votes from the 63-member House GOP caucus before allowing the bill to go to a vote, calling that "a lie. It just isn't true." Hughes said he wanted the 38-vote level of support to take a House caucus position, but he would not have prevented the bill from going to a vote if the governor had called a special session and it had come up shy of the threshold.

gehrke@sltrib.com Twitter: @RobertGehrke