Gov. Gary Herbert is walking a political tightrope.
On one side, the fiscal conservative in him has to feel rotten about the millions of federal dollars that would already have been pumped into the Utah economy if he could have found some way to expand the Medicaid program as provided in the Affordable Care Act.
On the other side, Herbert the savvy politician has to worry about the fallout he will suffer if many of the more active members of his own Republican Party perceive or claim that the state is doing too much to provide health care benefits to what Alfred P. Doolittle perceptively referred to as "the undeserving poor."
Part of the solution, apparently, is to make at least some of the recipients of the half-baked "Healthy Utah" plan a smidgen less undeserving.
Even if it means hurting the chances that the Obama administration will accept his waiver application. Even if it means delaying, by months or longer, the day when more than 100,000 Utahns can avail themselves of something that every single civilized nation on the planet except this one considers basic to human life: access to health care.
Herbert's plan starts off by cutting in the very middlemen Medicaid is supposed to cut out, the insurance companies whose overhead seriously diminishes the amount of money available to pay doctors and hospitals for real health care.
His plan also envisions imposing a co-pay provision and some kind of work requirement for "able-bodied" recipients. Such rules would serve the purpose of making the acceptance of Healthy Utah benefits more bureaucratic, expensive and complicated. Somebody, after all, will have to fill out the forms and conduct the hearings needed to separate the able-bodied from the disabled and the co-payers from the can't-payers.
It may frighten off just enough of the people that Utah's one-party ruling class can congratulate itself for frustrating President Obama's goal of expanding health care access to millions of previously ignored Americans.
The work requirement would be similar to the one already imposed for adult recipients of food stamps. Except the state may tighten that rule to no longer allow volunteer service at such places as charity food pantries to count.
That would diss the poor twice over, denying the worker an incentive to contribute to the community and the charity the benefit of some needed free labor.
Clearly, Utah's leaders will spare no expense in making sure that being poor here hurts just as much as possible.