Senator looks to bring work requirements back to Medicaid expansion
January 12, 2019
Sen. Allen Christensen, who represents northern Summit County in the Utah Senate, says he is looking into a proposal that would modify the full Medicaid expansion voters passed last November to, among other things, institute a work requirement for recipients, estimated to be up to 100,000 people.
The expansion through the Affordable Care Act will be funded through a hike in the state sales tax rate along with state and federal monies. The North Ogden Republican said the voter-approved plan has technical issues that need to be rectified if the system is to remain stable, and that the tax increase wouldn't cover the state's overall cost. Christensen's proposal would implement a cap on enrollment in the event funds run out.
"That money has to come from someplace, and we are trying to make it as complete of an expansion as possible but it has to be affordable at the same time," he said.
Christensen plans to introduce the bill during the upcoming legislative session, which begins Jan. 28.
Beth Armstrong, executive director of the People's Health Clinic and a prominent supporter of full Medicaid expansion, called Christensen's view on whether the tax increase would cover the cost of the law "dead wrong."
She and other advocates believe that the plan would be a net financial gain rather than a burden.
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"Not only does it cover the cost," Armstrong said, "we're also expanding jobs, we're creating new jobs, we're expanding the economy and increasing the GDP."
The proposed work requirement is one area of particular contention in the debate over expansion, and it requires the additional step of submitting a waiver to the Trump administration for approval. Work requirements have long been part of conservative lawmakers' efforts to expand Medicaid across the nation, the idea being that they would help offset the economic cost of expanded health care by ensuring recipients are contributing to the economy. Work requirements were included in a scaled-back expansion plan approved by the Legislature last year that was superseded by the voter-approved alternative.
Armstrong said she believes the omission of the work requirement from the law voters passed is the reason lawmakers are looking to alter it.
"Ninety-seven percent of my patients have at least one job," she said. "These are not people who are looking for handouts."
Christensen said that proposals such as his and the legislative compromise reached on medical marijuana before the election are an example of why legislators are needed.
"This is a representative democracy that we have here and they (voters) elect us to spend the hours and hours and spend the time to implement the programs in order to work," he said. "When we get the people to vote on something and implement something and it's half of the people, or slightly over half of the people, who wanted that, if we ran the bill again … it would overwhelmingly pass even better than Prop 3 did."
Proposition 3, the Medicaid expansion ballot measure, passed with a margin of 53.3 percent to 46.7 percent.
"I'm trying to make it responsible," Christensen said, saying that running into issues with the system down the road would amount to breaking a promise to voters.
Armstrong said she is frustrated with the outcome of both the medical marijuana compromise and the proposal to alter the Medicaid expansion law after its passage.
"Why do we have the ability to have a ballot initiative if you're not going to honor it," she said. "When a voter votes, that's the answer."
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