Utah Senate: No interest in banning Medicaid expansion

Senate Republicans have no appetite now to take up a House bill shutting off the possibility of tapping into federal funding for expanding Medicaid to cover an estimated 131,000 uninsured, low-income Utahns.

The 24 Republicans among the 29 senators met in a closed caucus Tuesday to discuss HB391S2, which would prohibit the state from taking any additional Medicaid money under the Affordable Care Act, also known as Obamacare, and there was not support for the bill, said Senate Majority Leader Ralph Okerlund, R-Monroe.

"We'll probably have to have that discussion sometime soon after the session," Okerlund said.

Sen. Todd Weiler, R-Woods Cross, has drafted amendments that would allow the state to expand Medicaid after the completion of a state Department of Health-commissioned study of the issue and a report from the Health Systems Reform Task Force on Utah's charity care system.

Weiler said he doesn't expect the bill, sponsored by Rep. Jake Anderegg, R-Lehi, to get heard on the Senate floor, but he wanted the amendment prepared in case it does.

Weiler, who sits on the Social Services budget committee, said Anderegg's bill was poorly drafted and premature, cutting off options before all the information is available.

"I'm not advocating for Medicaid expansion. I'm advocating for: Let's follow a timeline. Let's follow a process," Weiler said. "We have three more years to make a decision. Why do we want to make it in the last three days of the session?"

Okerlund said that Gov. Gary Herbert also would have to include the Legislature in the decision-making, since lawmakers would have to approve the funding tied to the expansion.

HB391 seeks to block Herbert from accepting federal money for the expanded Medicaid coverage.

The Act would expand Medicaid to cover people making 138 percent of the poverty rate.

For three years, it would be paid for entirely by the federal government, with the state picking up more of the cost in later years, climbing to 10 percent in 2021 and beyond.

The Legislative Fiscal Analyst has estimated it would save the state about $6 million in the first year — because it would cover many of those in state custody or care — and nearly $16 million in the second year.

However, Anderegg argued that the Medicaid expansion would be unsustainable, given the national debt, and that Utah can provide for its own uninsured through charity care.

On Monday, Senate President Wayne Niederhauser, R-Sandy, said he expects states will try to persuade the federal government to "get their fiscal house in order" before expanding Medicaid.

"If that fails, then as each state goes ahead and expands, Utah will probably end up doing that at some point because it's a 'we want our share of the pie' type thing. Why wouldn't you do it at that point?" he asked.