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When President-elect Donald Trump is inaugurated Jan. 20, the fate of Utah's small-scale Medicaid expansion plan will be up to his administration.

And health officials say that probably means approval of the plan is still far away.

"It could be a long time unless the Utah [plan] is viewed as an example the Trump administration wants to use to a set a standard for all future" plans," said Jason Stevenson, education and communications director for the Utah Health Policy Project. "If we're the guinea pig, that would accelerate the approval process."

State officials initially estimated that the plan, projected to cover 9,000 to 11,000 Utahns, would be approved by the feds in time to start enrolling eligible individuals by Jan. 1. It targets childless adults who are chronically homeless, are involved in the justice system, or need mental-health or substance-abuse treatment. The plan also expands coverage of low-income parents with dependent children previously not covered by Medicaid.

The state, however, recently heard that the Centers for Medicare and Medicaid Services (CMS) would not decide on the plan before President Barack Obama leaves office. Instead, it will leave the decision up to the Trump administration, said Kolbi Young, spokeswoman for the state Department of Health.

"We have no expectation of timeline for when the new administration will be in place to review and decide on our submission," Young said.

The CMS under the new administration eventually could rule on the plan, Stevenson said, or it might send the plan back to Utah officials and ask them to try again.

"I envision this going around the bend once or twice more," he added.

State officials also could withdraw the plan and try again, this time with provisions such as work requirements that were nonstarters under the Obama administration, Stevenson said.

State Rep. Jim Dunnigan, R-Taylorsville, who sponsored legislation outlining what the plan should include, said he had no intention of doing that, nor does he plan to push through a measure to submit a competing Medicaid expansion plan to the feds.

"It's unfortunate that the outgoing administration just didn't approve" the plan, Dunnigan said. "This is supposed to be a demonstration waiver where states are allowed to demonstrate new ideas, ways and concepts, try them out for three years or whatever, and see if it works and, if so, other states may want to do it."