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Poll: Legislature didn't go far enough with Medicaid expansion

SALT LAKE CITY — Most Utahns want the Legislature to expand Medicaid further, according to a UtahPolicy poll — the first survey on the topic since state lawmakers decided to extend Medicaid to around 16,000 of the poorest Utahns.

The poll, conducted by Dan Jones & Associates, found that 51 percent of respondents believe Medicaid should be expanded to cover all remaining low-income uninsured Utahns.

Nineteen percent said the 2016 Legislature's plan is adequate, 18 percent said Medicaid should not be expanded at all, and 12 percent said they didn't know.

Chris Karpowitz, co-director of the Center for the Study of Elections and Democracy at BYU, said the results are consistent with previous polls.

"Many Utahns favor full Medicaid expansion or at least additional expansion beyond what the Legislature has passed to this point," he said. "That's a pretty consistent result over multiple surveys."

UtahPolicy polls in February and January showed that between 68 percent and 70 percent of respondents strongly or somewhat support some form of Medicaid expansion.

A 2014 poll of Utah voters conducted by BYU showed that about 43 percent supported the governor's Healthy Utah expansion plan, 33 percent supported traditional Medicaid expansion, and 11 percent supported partial coverage.

Those surveys were conducted before the Legislature passed HB437, which extends Medicaid coverage to certain needy Utahns, including the homeless.

Before that, state lawmakers spent several years debating multiple Medicaid expansion proposals.

Sen. Brian Shiozawa, R-Cottonwood Heights, said the UtahPolicy poll shows that partial extension is not enough.

"I'm glad we did something, but honestly the reason they did that was to get something on the books," Shiozawa said of HB437. "We need to get this full expansion done."

Shiozawa, an emergency room physician, said Utah should have gone with a fuller expansion like Healthy Utah years ago.

"We would have been already addressing this problem and recouping the benefits of the federal money and helping these patients," he said.

But House Majority Leader Jim Dunnigan, R-Taylorsville, said the cautious approach taken by lawmakers was the right move.

He pointed to states such as New Mexico and North Dakota — where Medicaid enrollment has exceeded expectations and state officials are now trying to rein in costs — as examples of expansion gone awry.

"I think what Utah did was a real prudent step," Dunnigan said. "We covered those most in need. It can be evaluated down the road, and people can decide if anything else should be done."

He also disputed some of the numbers cited by supporters of expansion, who say the state is forgoing some $500 million in federal matching funds by refusing to expand Medicaid.

Some $300 million to $400 million of that would be offset by the thousands of Utahns who are currently getting subsidies but would be switched to Medicaid, according to Dunnigan.

"I'm not sure people understand all of the nuances of Medicaid expansion," he said, adding that the media often reports "just the surface numbers."

The issue has divided Utah's gubernatorial candidates, who sparred at a Utah Foundation luncheon March 24 about Medicaid expansion

At the luncheon, Gov. Gary Herbert said the Legislature's partial extension plan is "incremental, but we'll be able to look at the data, build upon that and hopefully expand to more people as we're able to afford it."

Republican challenger Jonathan Johnson opposes Medicaid expansion, arguing that the mandate to buy insurance and uncertainty around costs are "not the Utah way."

Democratic candidate Mike Weinholtz, the former CEO of health care staffing company CHG Healthcare Services, called the Legislature's partial expansion plan a "death panel" because of the tens of thousands of Utahns who are left out.

"We need to expand Medicaid fully," he said. "That's what Utah values are. We take care of our people."

Democrats and Republicans are sharply divided on the issue, according to the poll.

The majority of Democrats — 87 percent — said Medicaid should be fully expanded, and 67 percent of political independents agreed.

Among Republicans, however, 34 percent said Medicaid should be expanded.

Lawmakers are likely being responsive to their "fellow partisans," Karpowitz explained.

"As long as the majority of Republicans are not in favor of further expansion, it strikes me as unlikely that further expansion will occur given our very Republican Legislature," he added.


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