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The Salt Lake County Council wants to let state officials know — again — that county taxpayers will end up footing a substantial bill if Utah does not go along with Medicaid expansion.

So the GOP-led council is preparing to write a letter asking legislative leaders to drop their resistance to at least Gov. Gary Herbert's compromise "Healthy Utah" proposal, which would tap public Medicaid dollars to buy private coverage for an estimated 111,000 Utahns, almost half of whom are county residents.

Council members also would like lawmakers to act on the matter in a special session this summer so the county can, starting at the beginning of next year, accept federal dollars for services rendered to the newly eligible Medicaid recipients.

But before finalizing the language of their letter, council members asked county human services director Lori Bays to provide them a clear description of the Medicaid options facing the county.

In addition, Councilman Sam Granato asked county District Attorney Sim Gill to determine what the county could do legally to go around the state and implement the federal plan if the Legislature sticks with its plan to reject federal money.

"There are 50,000 people in Salt Lake County who would benefit from Medicaid expansion," said Granato, who is in his first term on the council but has been on the county board of health for several years. "This is absurd and unconscionable to me."

The east-side Democrat lambasted legislative leadership, which is Republican, for resisting the federal proposal even though it means that $250 million in federal funding earmarked for Utah would go to other states that accepted Medicaid expansion.

"Are other states' citizens more important than our own?" he wondered aloud. "I'm not willing to sit back to wait for the [state] politicians any longer."

Councilman Steve DeBry, a Republican, noted the council voted for some sort of Medicaid expansion last year, when he was council chairman. He knows the governor is aware of the county's concerns about the financial impacts it would bear if federal aid is rejected.

"I appreciate where Sam's heart is on this and agree we should have a look-see," said DeBry, calling for discretion in a new letter's wording. "We shouldn't try to circumvent or go into someone else's realm and try to conduct their business for them."

Replied Granato: "I'm not telling them how to do business. But they're getting into our business and affecting the dollars we have to spend."

Council Chairman Michael Jensen, a Republican who is active in lobbying legislators on matters involving the county, firefighting and water, said the council could come up with appropriate language after receiving staff reports.

"I agree with Sam. Everyone around this table pays federal taxes. Why not have them come back instead of giving ours to other states for vital services that have societal health and educational impacts?" he said. "I don't think anyone [on the council] would argue differently."

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