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Editorial: Refusing Medicaid expansion is a dreadful idea

Published February 27, 2014 5:22 pm

Herbert's awful Medicaid alternative
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Gov. Gary Herbert's proposed "Healthy Utah" alternative to the Affordable Care Act's Medicaid expansion is a dog's dinner of denial, pipe dreams, contempt for the poor and lack of candor with the taxpayers of his state.

It's still better than the alternative proposed by the leadership of the Utah House, which ignored federal money altogether and pretended to do some good with a fraction of the funds, siphoned from other state needs.

Herbert's plan would be better if there was a snowball's chance that the federal government would grant the waivers needed for what is, in fact, an ideologically extreme plan.

That plan is to stop the ACA, aka Obamacare, from moving Utah up to the level of the civilized world by including thousands more people in the ranks of those with access to affordable health care.

The ACA offers tax subsidies for much of the middle class to buy insurance on a much-more-regulated private market. Many of the working poor, not included in those subsidized plans, were supposed to be added to the existing federal-state Medicaid program.

But the requirement that each state join that expansion was struck down by the U.S. Supreme Court, leaving the fate of the near-poor uncertain. That is what Herbert, misleadingly, refers to as the ACA's gap, a chasm that was not in the law until it was placed there by the court's decision.

Even many Republican-dominated states have accepted expanded Medicaid. They were more reluctant to pass up so much money, for such a worthy goal, than they were eager to sabotage President Obama's signature accomplishment.

Utah politicians, meanwhile, have been fighting over just how foolish and hurtful they can be in not only rejecting federal Medicaid dollars but in pretending that they have a better idea. They don't.

Herbert's plan is to ask the federal government to give him the money it would have spent on Medicaid expansion in Utah so he can use it in a scheme to shame a much smaller number of working-poor Utah families into a higher-overhead program to buy insurance from the very increased-overhead middle-men the ACA wisely sought to exclude.

Even though Herbert had said that "doing nothing" was not an option, his decision to seek federal waivers that won't be approved for months — and probably won't be approved at all — amounts to doing nothing while pretending otherwise.

It also amounts to leaving on the table upwards of $500 million in federal money that would have provided Medicaid coverage, employed doctors, nurses, orderlies, secretaries and pharmacists and significantly boosted the Utah economy. All because he and other state politicians are in a race to the bottom.







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