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State officials send feds Medicaid expansion plan for low-income parents

Published February 3, 2017 10:43 pm

Health • Expanded coverage is called a "good step," but it would affect relatively few families.
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As Utah officials continue to wait for federal approval of their small-scale Medicaid expansion plan, they hope to expand coverage to some parents.

Tom Hudachko, state Department of Health spokesman, said Friday that the federal Centers for Medicare and Medicaid Services (CMS) "verbally indicated" to state officials late last year that it would approve that part of the expansion, covering low-income parents with dependent children.

The state has submitted a separate plan focused solely on that group. It would cover an estimated 3,000 to 5,000 low-income parents currently not covered by Medicaid, a program designed to deliver care to low-income individuals and families.

"We still need formal approval but don't imagine this will be an issue," Hudachko said.

Micah Vorwaller, a health policy analyst for the Utah Health Policy Project, called the state's decision to proceed "a good step," but noted that it will only affect a small number of residents.

"This does help some Utah families," Vorwaller said. But, he added, "what would have been a mini-expansion under [the original plan] now is just a mini-expansion of a mini-expansion."

In a statement, Gov. Gary Herbert called this smaller, parent-only portion "a modest, but important expansion of Medicaid to support some of our most vulnerable families."

State officials initially estimated its small-scale expansion, projected to cover 9,000 to 11,000 Utahns, would draw federal approval in time to start enrolling eligible individuals by Jan. 1.

In addition to expanding coverage for low-income parents with dependent children previously not covered by Medicaid, the plan also would target childless adults who are chronically homeless; involved in the criminal-justice system, or need mental-health or substance-abuse treatment.

But President Barack Obama's administration decided not to rule on the overall plan, leaving it instead up to President Donald Trump's administration. They have not yet made a decision.

Vorwaller said it's unlikely the federal government will act quickly on the state's original plan.

Given the broader conversation on health care reform, he said, "it doesn't appear that there's going to be a lot of pressure placed to try to move that forward."

But the low-income parents portion by itself has a much better possibility of approval, Vorwaller said, because it is not specific to the Affordable Care Act, which President Trump and congressional Republicans have targeted for repeal.

Despite this, Utah saw an overall increase in ACA enrollment compared to last year. As of Tuesday — the last day of 2017 sign ups — 197,187 Utahns had signed up for health insurance on the exchange, compared to 175,637 this time last year. The Beehive State ranks third for its overall growth rate this year compared to last, behind Hawaii and South Dakota, according to the Utah Health Policy Project

Trump's administration "theoretically could find a way to stall [the parents-only plan]," Vorwaller said. But "I don't foresee that being a big problem," he added.

Utah's legislative leadership sent a letter on Monday to Herbert urging support for moving forward with the parents-only portion.

"We encourage the Department of Health to implement this section of [the bill] and increase eligibility for the parent population," the letter states.

Department officials anticipate that the parents-only plan will be approved in time to begin enrolling individuals July 1.

The plan will cost the state about $5 million to $7 million, Hudachko said, but these funds already were appropriated last year as part of the small scale plan.


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