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Will Utah Ever Close the Coverage Gap?

Andrea Smardon
Utahns in the coverage gap Stacy Stanford, Kylie Toponce, and Dan Davidson wait at the Capitol during a closed-door House GOP caucus meeting. (October 13, 2015)

The latest proposal to expand Medicaid in Utah was overwhelmingly rejected by Republicans in the House of Representatives this week, but lawmakers may have a way forward. 

After Utah Republicans voted down this recent plan, House Speaker Greg Hughes suggested that the GOP caucus may never be comfortable with the federal requirements associated with a Medicaid expansion. In order to receive 450 million dollars per year from the feds, Hughes says the risks the state would bear in terms of undefined costs are too high, but that isn’t to say they’re giving up.

“We do have the political will to help the needy,” Hughes says. He and other House Republicans would like to see a plan that focuses on helping only the most medically frail or poor – an estimated 31,000 people - even if it means losing federal money available through the Affordable Care Act.

“Because we’re not dealing with a behemoth of a federal government and all its regulations, we might be able to find a way to get water at the end of the row, and help those who truly need it without it being such a larger plan and having to comply with the ACA regulations,” Hughes says.

If Utah refuses to expand up to 138 percent of the poverty level, the federal government will not provide 90% of the funds, and the match rate would drop to 70%. Speaking on KUER’s RadioWest, Republican Senator Brian Shiozawa says this may be the best option to get House majority support, but he would rather see a full Medicaid expansion.

“We get the enhanced federal match, all the hundreds of millions of dollars coming back to the state of Utah, creating thousands of jobs. We would alleviate the medical issues and enhance the access for thousands of Utahns who currently don’t have that,” Shiozawa says. “Now you show me something that makes more sense than that, and I’ll embrace that.”

In the meantime, there are about 53,000 Utahns who remain in the coverage gap, and Utah taxpayers continue to send about 750 million dollars a year to the federal government. The state receives at least 340 million of that for subsidies, but the remaining money goes into a Medicaid program that the state has not accepted.

Andrea Smardon is new at KUER, but she has worked in public broadcasting for more than a decade. Most recently, she worked as a reporter and news announcer for WGBH radio. While in Boston, she produced stories for Morning Edition, Marketplace Money, and The World. Her print work was published in The Boston Globe and Prior to that, she worked at Seattleââ
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