SALT LAKE CITY — A bill backed by House GOP leadership extending Medicaid to Utahns who are homeless, in the criminal justice system, or have substance abuse or mental health issues is headed to Gov. Gary Herbert.
HB437, sponsored by House Majority Leader Jim Dunnigan, R-Taylorsville, passed the Senate 19-8 Tuesday afternoon, after being approved earlier in the day by the Senate Health and Human Services Committee.
The governor has said he would sign Dunnigan's bill, which extends traditional Medicaid to more than 16,000 mostly childless Utahns living in extreme poverty at a cost to state taxpayers of about $15 million.
The remaining $85 million cost would come from the federal government and Utah hospitals, which benefit by not having to absorb unpaid emergency room visits and have agreed to pay 45 percent of the state's share.
Herbert spokesman Jon Cox said after the vote that the "governor continues to be supportive of helping the poorest of the poor in our state. This legislation will help accomplish that goal."
"This is better than doing nothing. This is doing something for a lot of Utahns who sincerely need the help," the bill's Senate sponsor, Sen. Allen Christensen, R-North Ogden, said.
But Democrats questioned why the state wasn't willing to accept the full Medicaid expansion offered under President Barack Obama's health care law and cover an additional 90,000 Utahns for about $4 million more in state funds.
"This is financial insanity," said Senate Minority Leader Gene Davis, D-Salt Lake City, the sponsor of SB77, which would bring in more than $530 million in federal funds annually to the state for full Medicaid expansion.
Senate Assistant Minority Whip Luz Escamilla, D-Salt Lake City, said she opposed Dunnigan's bill because it left out too many people in need.
"I think it's irresponsible to let down our working poor families in Utah," Escamilla said.
Christensen called the comparison Davis made between two plans "extremely misleading" and warned that Medicaid expansion would leave the state financially vulnerable. "We're at the mercy of whoever shows up," he said.
Earlier Tuesday, Dunnigan's bill passed the Senate Health and Human Services Committee 5-1, with only Escamilla opposed.
Christensen, a member of the committee, said he was "sad" there was opposition to the bill "because they didn't get everything they wanted and so they would just as soon nobody got anything."
Republicans have expressed concerns about controlling Utah's share of the costs under full Medicaid expansion even though the federal government offers states a higher match than traditional Medicaid, as Dunnigan's bill uses.
Those concerns stalled efforts by the governor last year to come up with a plan to use the money available under Medicaid expansion for a state-run plan to ensure everyone in the so-called coverage gap received health care.
Herbert's Healthy Utah plan passed the Senate in 2015 but failed in the House. An attempt over the legislative interim by the governor and House and Senate GOP leaders was also unsuccessful.
Christensen, a longtime opponent of Medicaid expansion, told the committee HB437 is a "great compromise" because it helps the most needy while providing financial backstops.
He said, too, that it may just be a first step.
"Seriously, hopefully in the future this will be a step, as we start to understand where the true costs are, the involvement, all of it, that we can expand further and control that expansion and the cost of that expansion in a reasonable way," Christensen said.
Dunnigan called the bill "a collaborative, bipartisan effort to provide and help those who really benefit from this." He said it would offset the need for some $20 million requested separately as part of the state's Justice Reinvestment Initiative.
Among those testifying in favor of HB437 at the committee hearing was Keith McMullin, president and CEO of Deseret Management Corp., the parent company of the Deseret News and KSL.
McMullin, who served in the Presiding Bishopric of The Church of Jesus Christ of Latter-day Saints, said, "While more must be done, this is a good step in the right direction."
He said as the incoming chairman of the Salt Lake Chamber, the bill is good for the economy "because those who are not productive can become productive and society can grow as a consequence."