Local lawmakers say it’s time to deal with Medicaid expansion
June 30, 2015
Utah has been dithering for several years on the question of accepting federal funds to provide health care insurance to needy Utahns.
The Supreme Court’s decision last week upholding a challenge to the Affordable Care Act’s (ACA) insurance subsidies made the landscape clear to Utah’s legislators, who continue to struggle with the law’s Medicaid expansion. While the lawsuit didn’t deal directly with Medicaid, it was the last major threat to what is colloquially called Obamacare.
Three of Summit County’s lawmakers in the Utah Legislature support the Medicaid-funded expansion called Healthy Utah that Gov. Gary Herbert negotiated last summer with the federal government: Sen. Kevin Van Tassell, a Republican from Vernal, Rep. Kraig Powell, a Republican from Heber City, and Rep. Brian King, a Democrat from Salt Lake City. Rep. Mel Brown, a Republican from Coalville, joined the majority in the Utah House of Representatives in voting against Healthy Utah when Democrats pushed for a vote.
Brown indicated that the Supreme Court decision hasn’t changed the dynamic.
"From what I understand, Obamacare is going to stay in place and the feds are not going to change anything, so that means I think Utah’s going to have a hard time with doing any expanded coverage," he said.
"I think we’re trying to be fair," Brown said, "but I think we’re trying to recognize that with our challenges with funding education and everything else, balancing the tax burden of our citizens, any great additional expenditure is going to be hard to deal with."
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King and Powell both said that while King v. Burwell didn’t address Medicaid expansion, a decision against the government would have made inaction in Utah easier. Herbert said he was "very disappointed" in the ruling. His official position is that he supports efforts at the federal level to repeal the law but feels obligated to get the best deal for Utah in the meantime.
Van Tassell said that everyone was "kind of sitting back and waiting for the court to make a statement." Now that that’s happened, he said, it’s time for action.
"It’s time to decide what we’re going to do," Van Tassell said. He said the Senate and the House have been in a "stalemate," with the Senate backing the governor’s plan while the House has been resistant, only offering support for a pared-down bill to provide health care insurance for "medically frail" Utahns.
That stalemate is supposed to be worked out by a small group of Republicans — the governor and lieutenant governor, Senate President Wayne Niederhauser, House Speaker Greg Hughes, House Majority Leader Jim Dunnigan, and Sen. Brian Schiozawa — that was formed at the end of the legislative session when no resolution had been reached. A special legislative session would be called later this summer to vote on the group’s recommended plan.
Van Tassell called the group a "gold-ribbon committee." King referred to it as "the Gang of Six." It’s the group everyone is now waiting on.
"If they can get to an agreement, we’ll have a special session," Van Tassell said. "We’re not going to go into special session not to be able to work something out."
King and Powell expressed frustration with the state’s glacial progress on the Medicaid-expansion issue.
"I believe that the Utah Legislature has taken far too long to make a decision on this issue," said Powell. "Any decision would be better than the delay that we have been experiencing. A few months to discuss this would have been reasonable. But a few years, which is what we have now taken, I think is inexcusable."
King, the minority leader in the House, expressed frustration with House Republicans who are "looking for any excuse" to avoid Medicaid expansion.
"They just present one objection after another," he said. "I’m beginning to question whether there’s any information that could be presented that would overcome the ideological objection that they have to the state providing assistance in the form of access to affordable health care for people who are really struggling to make ends meet."
Van Tassell, King and Powell all agree that the status quo is untenable.
"I think that with the money we’re paying into it, I think we need to be getting some back," Van Tassell said.
"As long as the ACA is in place, we cannot deny the reality that we are paying millions of dollars as Utah taxpayers to the federal government that are intended to provide coverage for low-income Utahns through Medicaid and those Utahns are not receiving those benefits," Powell said.
"The fact is, whether we opt in to Medicaid expansion or not, we have been paying and will continue to pay enormous amounts of money to the federal government for our share of the costs of Medicaid expansion," King said. "If we choose to take that money — great, we’re smart. If we don’t choose to take that money, it’s not like we’re going to get the dough back. It is financially irresponsible."
Aside from the financial aspects of health care reform, King lamented that the other major aspect is not often discussed by opponents of the expansion — "the intangible improvement in the quality of people’s lives."
"What’s the value of being able to have access to health care if you’re currently one of the 150,000 Utahns who don’t have access," he asked. "I just wish that we had people on the other side who are willing to be honest in acknowledging both the costs and the benefits."
"I think this is the most important issue as a public policy matter that we’ve seen come before us in the Legislature in many years," he said. "We’ve got pressing issues every year, but in terms of the effect this has on people’s lives, I think there’s a good argument that this is the most important thing that we’ve seen for many, many years. And we’re completely blowing it."
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