"Many seniors don't understand the risky course the state has set for them," he said, referring to the Republican governor's signing of legislation to join an interstate "Health Care Compact" to wrest control of Medicare and Medicaid away from the federal government.
To date, seven states have signed onto the compact, which must be approved by Congress. Some have wagered that's unlikely.
"This is not a vision. It's political dogma," said Cooke. Nevertheless, the so-called "message bill" is "the law of the land," said the retired two-star general and real estate developer.
Were it to take effect, Utah would sacrifice $217 million in federal funds by 2014 and $1 billion by 2022, because funding for the compact is not designed to keep pace with medical inflation, he said.
The idea is that states won't need the money because they can administer the programs more efficiently.
That may be true, said Cooke, who offered no alternative reform plan, and said he isn't opposed to state control as long as it doesn't entail forgoing Utah's share of the federal tax pool.
"We pay those taxes," said Cooke. "Why would my opponent ask for less money than we are entitled to ... less money than 43 other states have already agreed to accept?"
Cooke's dollar figures match those cited by consumer advocates. But they include funding for Medicare, which a Legislative Health Reform Task Force is recommending the state leave alone for now.
There are about 260,000 seniors on the retiree health program.
Lawmakers want to proceed with the compact, but start slow, taking full command of Medicaid and leaving Medicare for another day, said Sen. Stuart Adams, R-Layton, at a recent task force meeting.
Whether that's possible under the compact as designed isn't clear.
Herbert's campaign issued a response, "Governor Herbert is a fiscal conservative who knows Utah can do more with less when the state government is in control. ... Utah already has some of the highest quality health care in the nation at the lowest cost."