SALT LAKE CITY — Thousands of slots in a state health plan for low-income adults could be defunded to help pay for the Legislature's partial Medicaid expansion plan.
Utah Department of Health deputy director Nate Checketts said the Legislature made the cuts under the assumption that most of the adults with dependent children on the state's Primary Care Network would switch to Medicaid if the extension passed.
The Legislature cut $600,000 from the Medicaid budget for fiscal year 2017 and $1.2 million each year thereafter under that rationale, he said.
"That was clear from the beginning, that people would move over," Checketts said. "I think what's really in question is whether those slots are back-filled or whether there's funding left to back-fill them."
Rylee Curtis of the Utah Health Policy Project said many advocates were unaware of the cuts until a meeting of the Legislature's Health Reform Task Force last Thursday. She expressed frustration that one low-income health plan may be trimmed to help pay for another and said the cuts further narrowed the impact of a $100 million plan that has already been pared down several times.
"Everyone who was working on this proposal or following in session was working under the assumption that 4,000 Primary Care Network slots would remain open," Curtis said. "That's 4,000 less people who will have even bare-bones coverage."
The House GOP's partial Medicaid extension plan was originally promoted as a way to cover 16,300 Utahns living in extreme poverty.
That number was revised to 10,000 after health department actuaries said patients would be more expensive than anticipated. That figure includes about 2,000 to 4,000 parents who are already on the Primary Care Network.
If those Primary Care Network slots are cut after the parents switch to Medicaid, Curtis said that means the extension will provide first-time coverage to about 6,000 adults — not the 16,300 many advocates expected when the bill passed.
"At the end of the day, it's like we hardly even made a dent in the Medicaid coverage gap," Curtis said.
The bill's sponsor, House Majority Leader Jim Dunnigan, R-Taylorsville, said he intends to keep the slots open.
He said it's unclear whether health officials will choose make the cuts to the Primary Care Network or absorb the costs elsewhere. That decision won't occur until the end of the year when the Legislature's fiscal analysts, the governor's fiscal analysts and the health department sit down to create a consensus budget, he said.
And he added that the Primary Care Network already has trouble filling all the available slots for parents.
"It's certainly my intent to keep the same number of enrollment," Dunnigan said.
The Primary Care Network serves about 18,000 low-income adults whose health issues are not severe enough to qualify for Medicaid but still significant enough to prevent them from accessing health care.
The network offers limited benefits including primary care, up to four prescriptions per month and limited emergency room coverage, and does not cover inpatient hospital costs or specialty care.
Parents stand to get significantly better benefits under Medicaid than the Primary Care Network, Checketts said.
The Utah Department of Health is collecting public comment on the Medicaid extension plan until June 8. State officials will send the final proposal to the federal government by July 1.
Email: dchen@deseretnews.com
Twitter: DaphneChen_