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Gov. Gary Herbert's push for his Healthy Utah plan for expanding Medicaid appears to be gaining traction in the Utah Senate, according to the sponsor of a competing, stripped-down expansion proposal.
"There seems to be considerable support for Healthy Utah," Sen. Allen Christensen, R-North Ogden, said Tuesday, after he made a pitch for his more limited Medicaid expansion to a closed-door Senate caucus.
Christensen said he believes the House won't pass Healthy Utah and, if the Senate does, it's possible no Medicaid expansion passes and nobody will be covered.
Christensen is sponsoring Senate Bill 153, which would extend Medicaid coverage only to those who are deemed "medically frail," a narrow definition that would cover between 8,000 and 10,000 low-income Utahns with medical problems or mental illness.
"It didn't go as well as I would have liked," he said.
Instead, support seems to be growing, Christensen said, for a bill sponsored by Sen. Brian Shiozawa, R-Cottonwood Heights, that would implement Herbert's Healthy Utah program.
The two conflicting proposals are now awaiting debate in the Senate which may not come until next week.
"I have discussed it and talked until I'm metaphorically blue in the face," Christensen said. "The governor's pulling out all the stops with his advertising and [Utah] Hospital Association and calling in all the favors he's ever had. There's a lot of pressure there."
Senate Majority Leader Ralph Okerlund, R-Monroe, said senators had a good discussion of both bills, but there was no clear direction for the body.
Christensen's SB153 which had been referred to as "Frail Utah," but now is being re-branded as "Utah Cares" would cover about 100,000 fewer people than Herbert's Healthy Utah plan at roughly the same cost. But Christensen says his bill would help those most in need and is a principled compromise between Herbert's plan and doing nothing.
"Is the state's responsibility to provide everything to everyone? I say, 'No,' " Christensen said. "Socialized medicine is not the responsibility, nor is it a constitutional guarantee of this country. America grants opportunities. It doesn't grant benefits."
Utah Department of Health Director David Patton told the Senate Health and Human Services Committee that he understands Christensen's objective but believes the governor's plan is a better, more cost-effective approach to insuring Utah's poor.
"He's trying to help individuals who are the most needy and I think he's trying to do that at a cost that I think he might consider the most reasonable cost," Patton said. "But there are some concerns we have with a medically frail bill, especially in contrast with some of the other options we have available."
Shiozawa, who is sponsoring a bill to implement Herbert's Healthy Utah plan, says SB153 provides only bare-bones health care at a high cost.
"The program you're proposing is woefully inadequate compared to Healthy Utah," Shiozawa said.
Christensen's bill passed the committee 4-2, moving to the full Senate.
Shiozawa's measure passed committee last week. Both bills are now awaiting consideration in the Senate.
Christensen's plan would cost $16 million in its first year and $28 million by 2021, bringing in $66 million a year in federal funds. Healthy Utah would save the state $2.4 million from its current Medicaid expense in its first year and cost $78 million a year by 2021, drawing $648 million in federal matching dollars.
House and Senate Republican leaders have said they plan to meet with their caucuses this week and possibly next week to get a sense of how their respective bodies plan to proceed.
House Republicans, without coming to any position, allowed two members, both doctors, to pitch Healthy Utah in Tuesday's caucus as the best prescription for the state.
Reps. Raymond Ward, R-Bountiful, and Edward Redd, R-Logan, both physicians, presented statistics and financial estimates, but they also used an emotional touch to press for Healthy Utah.
Ward passed out obituaries of some of his former patients who died young because they could not afford appropriate health care.
"If you want to know whom Healthy Utah would cover, it's them," he said. He said other plans would leave such people to fend for themselves without coverage.
Redd said the plan could treat and cure many people he treats at a Cache County clinic and jail who have mental illness, addiction problems and other serious sickness with expanded coverage. He said that would increase productivity and tax revenues while cutting costs.
Lee Davidson contributed to this report.