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Republican leaders of the Utah Legislature appear poised to take the first cautious steps toward expanding Medicaid to help the poorest of the poor get health care, with the potential to broaden the program in the years ahead.

House Majority Leader Jim Dunnigan is drafting legislation that would tap $30 million of state money and another $70 million in federal matching dollars to extend Medicaid coverage to the lowest-income Utahns, those with mental illnesses or addiction issues.

"It will cover 16,000 adults not currently eligible and then we can get some Utah-specific data on what the costs are and what the take-up rate is and give people the opportunity to improve their lives," said Dunnigan, who has been the point person in the House on the Medicaid issue.

The Taylorsville Republican plans to pay the state's share of the coverage with tax dollars and an additional tax on hospitals.

The Utah Hospital Association has said in the past its members are willing to pay part of the cost for the Medicaid expansion because they would benefit from not having to absorb uncompensated emergency room care.

Senate President Wayne Niederhauser said he believes that the Senate will pass whatever bill makes it through the House.

"It's the art of the possible, and something is better than nothing," the Sandy Republican said.

"I think what we're going to do is take a more incremental approach to this," he said. "At first it seems like, why don't we just take the money and move forward and then deal with the problems that arise later on? … But if we take an incremental approach, then we get the 10, 20, 30 percent of the population covered now, in a couple years we'll increase that and then, by 2021, we've got [those below poverty] covered through traditional Medicaid."

Other proposals also are pending in the Legislature.

Rep. Ray Ward, R-Bountiful, has a bill that would use a tax on e-cigarettes and an assessment on hospitals to help subsidize insurance for all 125,000 Utahns making less than 138 percent of the poverty level. The measure is similar to Gov. Gary Herbert's Healthy Utah proposal that was rejected last year by the House.

Sen. Brian Shiozawa, R-Cottonwood Heights, is sponsoring a bill that would subsidize insurance for those below the poverty level, assuming the federal government agrees to pay 90 percent of the cost, as opposed to the normal 70 percent rate. The Obama administration has refused to make that concession in the past.

And Sen. Gene Davis, D-Salt Lake City, is proposing legislation that would extend traditional Medicaid benefits to the 125,000 low-income Utahns — as originally envisioned under Obamacare.

Twitter: @RobertGehrke