This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Utah legislators paid no mind to what their constituents thought when they approved a sort of Medicaid expansion plan that isn't even substantial enough to earn the label "bare bones."

It is only now, months after the Legislature acted and years after the issue arose, that anyone will be formally seeking public comment on the sliver of assistance that will be offered by the passage of House Bill 437. And even that is only happening because the federal government requires it.

Comments will probably fall into one of two categories.

One, from the heart, will echo what Salt Lake County District Attorney Sim Gill said last week. That the plan is "a failure of public policy." That many thousands of Utahns will still lack levels of health care that have long been taken for granted by the citizens of nations — and, now, of some states — that deserve to be called civilized.

The other, from the head, will be more like those from some of Gill's fellow Democrats, Salt Lake County Mayor Ben McAdams and Salt Lake City Mayor Jackie Biskupski.

The plan will, the mayors noted, help with local efforts to fight homelessness and to implement the state's reforms of the criminal justice system.

Of course, like Gill, McAdams and Biskupski would have preferred the full Medicaid expansion that would have come with the federal Affordable Care Act if the U.S. Supreme Court hadn't engaged in some conservative judicial activism and turned the ACA's Medicaid mandate into a state option.

And many Utah Republicans preferred Gov. Gary Herbert's a private-sector alternative called Healthy Utah.

But House Speaker Greg Hughes and Majority Leader Jim Dunnigan are allergic to anything that helps the working class or implies that President Obama might have had a good idea. So, with Healthy Utah dead in its tracks, the mayors and the governor took what they could get.

That plan, focused on the chronically homeless, the mentally ill and those in the criminal justice system, is different enough from the ACA vision that it requires a waiver from the U.S. Department of Health and Human Services.

That is the trigger for a series of public hearings and an opportunity for people to make their views known online. (Details at health.utah.gov/MedicaidExpansion/ )

It wouldn't help much to oppose the plan now, as the only realistic alternative, were the feds not to approve it, would be for nothing at all to happen.

Real improvement will take a revolt at the polls and a Utah Legislature that's as intelligent and decent as the people of the state. Something no public hearing will provide.