SALT LAKE CITY — The House passed a bill Monday requiring the Utah Department of Health to submit a waiver request to the federal to government to provide Medicaid benefits to thousands of low-income Utahns.
HB472 would expand coverage through a managed health care plan for people making less than the federal poverty line — $12,060 a year for individuals and $24,600 for a family of four. It includes a work requirement and path to self-sufficiency for able-bodied recipients, and a cost cap.
Rep. Robert Spendlove, R-Sandy, said Medicaid expansion plans proposed three year ago went too far and exposed the state to unsustainable financial risks and potential out-of-control cost increases.
"We correctly decided at that time not to act," he said before the House passed his bill 47-27. Eight Democrats voted for the measure, while four joined some of the more conservative Republicans voting against it. The bill now goes to the Senate.
Democrats have pushed to expand Medicaid for people up to the maximum 138 percent of the poverty line. HB472 proposes to expand Medicaid to 100 percent of the poverty line.
Spendlove said times have changed under the Trump administration.
"We now have a willing partner in the federal government who is working with us and encouraging us to develop a Utah solution to this issue," he said.
The state would spend no new money on the program, which goes away automatically if the federal government goes back on the agreement, Spendlove said.
Rep. Bruce Cutler, R-Murray, said lawmakers can now do all the things they couldn't under the Obama administration and not cost the state any more money.
"To me, that's almost a miracle, therefore I certainly support this," he said.
Chase Thomas, policy and advocacy counsel with Alliance for a Better Utah, said lawmakers shouldn't be too quick to pat themselves on the back for doing something they could have done three years ago.
Also, the federal Center for Medicaid Services did not approve a request from Arkansas to lower its Medicaid coverage from 138 percent to 100 percent. He said that casts doubt on Utah obtaining a waiver for its program.
"Regardless, even in the case that it was approved, this proposal would leave tens of thousands of Utahns out of the Medicaid expansion program," Thomas said in a statement.
Full Medicaid expansion would not put the state in the "doom-and-gloom" financial situation legislative leaders would have people believe, he said.
"However, it would help many more Utahns who desperately need that help," Thomas said.
Meantime, a bill requesting that Utah fundamentally reshape how Medicaid is funded, or alternatively to attach a work requirement to the program, stalled in another committee Monday despite being revived last week after it was turned down by the House Health and Human Services Committee.
After the human services panel said Thursday that SB172 should be studied further, the House Rules Committee opted to Friday to revive the bill by sending it to the House Revenue and Tax Committee.
On Monday, that body unanimously opted to hold the bill.
SB172 sponsor Sen. Dan Hemmert, R-Orem, told fellow lawmakers that his bill was designed to give greater flexibility to the Utah Department of Health to make more of its own decisions about how to administer the Medicaid program.
Several representatives from Utah health advocacy organizations criticized SB172 as a measure forcing the state into decisions about which groups of people would have their Medicaid access curtailed, and also complained it was dangerously vague.
Philanthropist Pamela Atkinson told the committee she has "some concerns with the picture that's being painted of people who are low-income and need Medicaid."
Sometimes, she said, those who are poor need better critical health coverage first in order to help them be more productive in the first place.
"They need to be healthy. They need be able to get … primary care," Atkinson said.
Dr. Bill Cosgrove, who represents the Utah chapter of the American Academy of Pediatrics at the Legislature and is also the vice chairman of the Utah Medical Advisory Committee responsible for counseling the program, said incremental changes to Medicaid over the decades has made it more efficient, per patient per year, than private insurance.