Editorial: State should heed county's Medicaid advice

Counties get no respect.

They are the level of government that sits between cities and states on the hierarchy of jurisdictions, least likely to catch the citizens' attention.

It's not that counties don't have important work to do. It's just that most of it is to provide the most basic of basic services, sometimes just for unincorporated areas, sometimes across multiple municipal boundaries. And a lot of it is for the poor and politically powerless.

Which is why a unanimous Salt Lake County Council has asked members of the Utah Legislature to get behind Gov. Gary Herbert's Healthy Utah proposal.

It is not just good advice. It is good advice from people who are much closer to the ground, much more directly in charge of funding and overseeing human service programs, much more aware of how an ounce of prevention can be better than a pound of cure.

Healthy Utah is Herbert's plan to take the $250 million in federal funds that would have gone toward the expansion of Medicaid in Utah under the Affordable Care Act, if it were politically possible to do so in this conservative state, and use it to buy private insurance for an estimated 110,000 Utahns who are currently without coverage.

County Mayor Ben McAdams and the members of the County Council care about that because they are responsible for various services to the most needy people among us, and Healthy Utah coverage for those people would save county taxpayers a lot of money even as it saves those same poor and powerless people a lot of misery.

Among those who would benefit if Herbert worked out the necessary waiver deal with the federal government, and if the Legislature ratified that deal, are some 3,200 people who are otherwise in danger of losing crucial substance-abuse treatment programs. The program would also go a long way to making sure that people being released from the county jail in coming months and years get the kind of care — especially mental health and substance abuse care — they need to build their own lives on the outside and avoid doing anything that would return them to prison.

If you've been paying attention, you know this space has argued strongly that Healthy Utah is inferior to a simple expansion of Medicaid. It is more bureaucratic, spends more on overhead (profit) for insurance companies and makes it just that much more difficult to sign up for.

Still, it's better than nothing. Salt Lake County Council members — five Republicans and four Democrats — agree. Their advice should be heeded.