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Utah's governor and state lawmakers will miss their self-imposed, July 31 deadline to reach a deal on Medicaid expansion.
Gov. Gary Herbert and a working group of GOP legislative leaders hope to pitch a compromise plan by the time the 2016 Legislature opens in January, House Majority Leader Jim Dunnigan said Tuesday.
For several years, state leaders have been unable to craft a plan to provide health care to Utahns who fall into a coverage gap under the Affordable Care Act (ACA). But many had pledged that this month's deadline was hard and fast. Now that, too, has been put off.
"It's been helpful to have some time go by," Dunnigan said in a news conference at the Capitol, noting that he recently picked the brains of legislative leaders in Illinois and Arkansas.
Advocates disagreed, slamming state leaders for running out the clock.
"These are real Utahns who are being left out of health care options," said RyLee Curtis, Medicaid policy analyst at the Utah Health Policy Project.
About 60,000 Utahns make too much money to qualify for Medicaid under the existing law, but they don't make enough to qualify for federal health insurance subsidies. That's because the ACA, or Obamacare, didn't set aside subsidies for those people. Its authors had expected each state to expand Medicaid programs.
Curtis notes that since the ACA went into effect in 2012, Utahns have paid taxes to fund the expansion.
Meantime, the health policy project released new findings backing Herbert's all-but-dead "Healthy Utah" plan.
Salt Lake City-based consulting firm Notalys compared the governor's plan with conservative lawmakers' less expansive option. Consultants concluded "Healthy Utah" would save the state roughly $600 million over time, as opposed to a leaner plan from the Utah House.
Dunnigan rejected the findings Tuesday.
It's "not much help," he said, noting Herbert's plan amounts to a rough draft that is undergoing heavy edits by the working group.
Still, Curtis counters, the analysis done on behalf of the policy project, AARP Utah and Voices for Utah Children shows full expansion by any name will earn the state better returns and insure more people.
Sven Wilson, the firm's chief economist, also a professor of Public Policy at Brigham Young University and a research economist at the National Bureau of Economic Research, was the lead researcher on the cost-benefit analysis released this week.
Working group members have offered few details about their negotiations, but Dunnigan said they want to put a ceiling on state costs.
In October, the Obama administration gave Herbert flexibility to craft a plan he believed GOP legislative leaders would get behind. The Republican governor calls for the state to use $250 million from the U.S. government to buy federal health insurance for Utahns at or near the poverty line.
His colleagues are not convinced.
Dunnigan and other House GOP leaders are concerned about the long-term implications for state and federal budgets.
Herbert had originally included a work requirement, but federal officials said that's against the law. Enrollees would be on the hook for a portion of their coverage costs under "Healthy Utah."
The Utah Senate threw its support behind Herbert's proposal during the 2015 Legislative session. But House members were not sold. They passed a plan that would tap state and federal coffers for primary care, but would not cover visits to the hospital or to specialists.
Last June, Notalys released poll results finding that Utahns favor Herbert's plan over other alternatives.