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In ongoing brinkmanship over how to expand Medicaid coverage for Utah's poor, the House on Friday passed its "Utah Cares" alternative.
It also again rejected Gov. Gary Herbert's "Healthy Utah" proposal which Democrats introduced as a substitute to force a vote to identify the friends and foes of the Senate-passed plan.
House leaders' Utah Cares alternative, HB446, passed 56-18. All those who voted for it were Republicans, while all of the House's 12 Democrats and six Republicans opposed it.
The amendment to replace Utah Cares with Healthy Utah earlier died 22-52. All Democrats supported Healthy Utah in that vote, joined by 10 Republicans.
Senate President Wayne Niederhauser said senators will give the House plan a hearing next week the final one of the legislative session even though the House initially declined to do so for the Senate's Healthy Utah bill.
Sen. Brian Shiozawa, R-Cottonwood Heights, sponsor of the governor's plan, said senators will still push Healthy Utah heavily going into the final week of the session.
But he left the door open for a compromise such as adopting the governor's plan for the next two years to take advantage of big federal subsidies, and then switching to the scaled-back House plan. Negotiations over such a melding are ongoing, he said, although he acknowledged it's possible the Senate might approve the House plan to prevent doing nothing.
The House debate on Friday, and also late Thursday, was sometimes raucous.
Thursday night, Democrats forced but lost a vote on bringing Healthy Utah to the floor for debate, even though a House committee had killed it a day earlier.
Tempers flared over the move, which also forced a vote to help identify opponents and supporters of Healthy Utah. GOP leaders hinted they will change rules to prevent such moves in the future.
On Friday, Rep. Rebecca Chavez-Houck, D-Salt Lake City, made a motion to erase the Utah Cares bill and replace it with Healthy Utah. House Speaker Greg Hughes, R-Draper, initially ruled the effort out of order over a technicality, but then reversed himself after discussion with parliamentarians.
"Please stop wasting our time," said Rep. Jacob Anderegg, R-Lehi, noting Healthy Utah had been defeated in committee and on the floor Thursday night. "It is unfortunate that this small minority in our body is more interested in headlines and gamesmanship than respecting the job they have been elected to do."
Healthy Utah supporters complained Anderegg's remark was a personal attack and thus, out of order. Hughes didn't rule on that dispute, saying he was talking on his phone and didn't hear the comment, but asked members to keep comments germane.
The previous night, Hughes had ruled Rep. Patrice Arent, D-Millcreek, out of order for comments criticizing Utah Cares supporters.
Chavez-Houck called the governor's Heathy Utah plan "a true compromise" worked out in depth by groups over a year, while the House alternative has had relatively little scrutiny.
House Majority Leader Jim Dunnigan, author of the Utah Cares bill, said it is sustainable over the long term, and does not depend on enhanced federal subsidies to work. He said the governor's plan does.
Utah Cares would cover everyone now living in poverty who lacks Medicaid, financed by a 70-30, federal-state match that is sustainable because Utah can set funding and coverage levels as it sees fit, Dunnigan said.
A big portion of those poor people, however, would be covered under Utah's bare-bones Primary Care Network, which provides no insurance for hospitalization, specialist care and many diagnostic tests.
People who make between 100 percent and 138 percent of poverty would be covered under so-called Obamacare by paying 2 percent of their income, he said, "and they get platinum coverage … similar to if we did Healthy Utah."
Arent said because the House plan avoids an enhanced 90-10 federal match negotiated by the governor for his plan, "It leaves so many of our federal dollars in Washington, D.C., that will never come back to our state. It leaves so many people without coverage."
But Dunnigan said, "Utah cares will return to our state hundreds of millions of dollar that we are paying."
The governor said Thursday that it makes no sense for the House to pass Utah Cares when it would cost $65 million to $77 million in its first two years, while Healthy Utah would cost $25 million. "Where's that money going to come from?" Herbert asked.
Herbert said his plan already has been molded to fit conservative objections in the House. It was trimmed back to two years and the governor has the Obama administration's assurance that the state could cap its costs and grandfather in those still on the plan when it ends in two years.
Utah Cares and Healthy Utah have roughly the same long-range price tag about $236 million for six years, the governor said. But Healthy Utah would bring back a net of $2.2 billion in federal funds in those years, helping Utah's economy while providing better care for more low-income Utahns, Herbert said.
Niederhauser said on Friday, "Healthy Utah is only $25 million in the first two years. Why wouldn't you take advantage of that?"
Sen. Jim Dabakis, D-Salt Lake City, said, "Utah Cares is really 'Pathetic Utah.' This is a sham. It costs the state of Utah a lot more money per person and it covers a fraction of the people. Why would we do this?"