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Utah is poised to ask the Trump administration's approval for its plan to extend Medicaid coverage to about 6,000 of the state's neediest childless adults, many of them chronically homeless or in need of mental health or drug addiction treatment.

State health department officials say they are a week away from submitting the plan, after receiving more than 230 public comments on details of their Medicaid expansion proposal.

This is Utah's second attempt to expand health coverage to this population after the Legislature last year passed — and Gov. Gary Herbert signed — a small-scale plan. That proposal still awaits federal approval more than six months past when state officials had hoped to begin enrolling individuals, on Jan. 1, 2017.

So, state officials have opted to modify their Medicaid plan instead, adding work requirements and other limits that had previously been nonstarters under President Barack Obama's administration.

The Utah Department of Health ended its public comment period on the latest proposal Thursday and received 233 comments, with 23 of those made during the two public hearings held over the past month in Salt Lake City.

Department of Health spokeswoman Kolbi Young said officials are reviewing the comments "to identify emerging themes" and will submit a synopsis to the Centers for Medicare and Medicaid Services on Monday, along with the proposal itself.

Health officials and lawmakers have said it's a "realistic" goal to begin enrolling targeted childless adults under the expansion by Jan. 1, 2018.

The state's proposed Medicaid changes include:

• A cap on enrollees in each of the newly added categories for coverage, at 25,000.

• A 60-month lifetime limit on coverage under Medicaid and the state's Primary Care Network for those new enrollees.

• A requirement that beneficiaries of the Primary Care Network, a Utah program that offers fewer benefits than Medicaid, either work 30 or more hours per week; seek employment; or participate in training unless they qualify for a half-dozen exemptions. That requirement has "the potential to be expanded" to Medicaid recipients "at a later date," state officials say.

• A $25 copayment for nonemergency visits by a Medicaid beneficiary to an emergency room.

• A limit on Medicaid coverage to the first day in the month that it was applied for, as opposed to the 90-day retroactive coverage Medicaid provides current beneficiaries.

State officials began enrolling between 3,000 and 5,000 low-income parents in a separate, already approved plan on July 1. About 2,500 of those parents are currently on the Primary Care Network plan and have already been identified for a shift to the more comprehensive Medicaid.

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