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Medicaid expansion up in the air as Utah Legislature passes halfway point

Senator Allen Christensen listens to comments at the State Capitol Building in Salt Lake City on Monday, Feb. 7, 2011. A bill that Christensen says tries to strike a compromise between full Medicaid expansion and not doing anything at all passed a Senate
Senator Allen Christensen listens to comments at the State Capitol Building in Salt Lake City on Monday, Feb. 7, 2011. A bill that Christensen says tries to strike a compromise between full Medicaid expansion and not doing anything at all passed a Senate committee Tuesday.
Kristin Murphy, Deseret News

SALT LAKE CITY — Opposing bills on Medicaid expansion have passed a state Senate committee as lawmakers continue to wrestle with proposals to provide medical insurance for needy Utahns.

Rep. Allen Christensen, R-North Ogden, said his plan tries to strike a compromise between full Medicaid expansion and not doing anything at all. SB153 would cover Utahns up to 100 percent of the federal poverty level and who are medically frail.

He initially called his proposal "frail Utah" but said he's now referring to it as "vulnerable Utah." He said it would leave money available for other needy groups "screaming" for government help.

"If we fully expand, there's going to be a lot of people out there that we buy insurance policies for that don't necessarily need or want them but we're going to spend that money for them anyway," Christensen told the Senate Health and Human Services Committee on Tuesday.

The committee approved the bill 4-2, allowing it to move to the Senate floor for more debate.

Meantime, as the 2015 Legislature passes the halfway mark, members of the Republican-controlled House and Senate have yet to reach an agreement on what they say is a generational decision.

"Right now we have a lot of energetic cases being made about different options," said House Speaker Greg Hughes, R-Draper. "We are not to a point where you're seeing the building of a proposal."

House Republicans had a detailed discussion on the governor's Healthy Utah plan Tuesday and intend to talk about Medicaid again Thursday.

Healthy Utah would help provide private insurance coverage for Utahns who earn up to 138 percent of the federal poverty level, including those who otherwise would not qualify for health care subsidies without a form of Medicaid expansion.

"Health care is like a complicated ecosystem," said Rep. Dean Sanpei, R-Provo, adding whatever lawmakers decide must achieve better access, care and outcomes without unintended consequences.

Senate Republicans have had at least two discussions to date.

"I think that a supermajority wants to do something," said Senate President Wayne Niederhauser, R-Sandy. "There are those who want to do nothing."

Niederhauser said he wants to keep both Christensen's bill and one by Sen. Brian Shiozawa, R-Cottonwood Heights, in play until senators agree which to move forward.

The Senate president said he personally favors a plan that would bridge the insurance coverage gap — those who earn too much money to qualify for Medicaid but not enough to get subsidized health insurance through the Affordable Care Act.

In the committee meeting, Shiozawa, whose bill backs Healthy Utah, questioned Christensen about his definitions of frail and vulnerable. The human services committee voted 4-1 to approve SB164 last week.

"This is news to me that you've renamed the frail moniker to vulnerable," the Cottonwood Heights Republican said. "Those are two different coverage groups if you use those terms."

Shiozawa called SB153 "woefully inadequate" in terms of Utah tax dollars the federal government would return to the state.

The medically frail option would cost about $200 million and bring back $611 million, according to estimates agreed upon by the Legislature and the governor's office. Healthy Utah would cost $236 million and return $3.2 billion.

David Patton, Utah health department executive director, said SB153 covers fewer people and returns less money to the state at nearly the same cost as Healthy Utah. He estimated 8,000 to 14,000 Utahns would benefit from Christensen's plan.

"It's been said this plan is better than nothing. I think that's true for the 14,000, but it is certainly not true for the other 80,000 people who are in the gap," he said. "It would potentially not cover needy individuals who are arguably as needy as people who are called medically frail."

Christensen said his bill does not close the medical coverage gap but narrows it. Closing it, he said, is a philosophical question.

"Is the state's responsibility to provide everything for everyone? I say no," he said. "Socialized medicine is not the responsibility nor is it a constitutional guarantee of this country. America grants opportunities. It doesn't grant benefits."

Healthy Utah would put 100,000 people into a "broken system" and bump people off Medicaid, putting them further down on the list of people who need assistance, Christensen said.

No Medicaid expansion proposals have had a committee hearing in the House so far.

House Majority Leader Jim Dunnigan, R-Taylorsville, said the two Senate bills could be retooled to fit a range of ideas House members are considering.

Email: romboy@deseretnews.com, Twitter: dennisromboy; DNewsPolitics