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Feds Approve First Step For Utah's Partial Medicaid Expansion

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Renee Bright / KUER
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Utah’s long waited Medicaid expansion proposal will move ahead. Officials received word from the federal government today that the state has received approval with the first stage of its Medicaid expansion plan, which is slated to start on Monday, April 1.

This first step in the expansion was nicknamed the “Bridge Plan” by lawmakers. The plan will expand Medicaid to an estimated 70-90,000 low-income Utahns who earn up to 100 percent of the federal poverty level, $12,492 for an individual or $25,752 for a family of four.

The expansion approved today is much narrower than what voters endorsed when they approved Proposition 3 last November. That would have expanded coverage to Utahns who earn up to 138 percent of the federal poverty line.

“Governor Herbert and his team have shown tremendous leadership by developing a sustainable Utah solution that extends coverage while helping to lift families from poverty instead of trapping them in public assistance,” said Seema Verma, administrator of the Centers for Medicaid and Medicare Services (CMS) in a statement on Friday.

Medicaid is paid for in partnership between states and the federal government. When states choose to change the program they must first get permission from the federal government with what’s known as a waiver.

The approval of Utah’s first waiver includes provisions for the state to cap Medicaid enrollment if the state runs out of money to pay their share. It also includes a work requirement that individuals complete a series of job searches and job training in order to find employment if they are not already working.

Earlier this week two other states — Arkansas and Kentucky — had their Medicaid work requirement provisions struck down by a federal judge. Judge James Boasberg from the District of Columbia argued that work requirements in those states didn’t sufficiently consider the impact of work requirements on the state’s Medicaid coverage. In Arkansas 18,000 Medicaid enrollees lost their coverage since work requirements were implemented last summer.

“This really shows the fragility of the legislature’s plan in the courts,” said Courtney Bullard, the education and collaborations director with the Utah Health Policy Project, a group that opposed the legislature’s Medicaid plan.

However, work requirements are not all identical. The proposals in Arkansas and Kentucky require individuals to work a minimum of 80 hours per week. Utah’s version has no requirement that individuals be employed but does require them to do job training and look for work.

“There’s a pretty big difference,” said Representative Jim Dunnigan (R-Taylorsville). “’While those cases, they might have some bearing on what we do, it doesn’t blow ours up because we’re not asking for the same thing that they have done,” he said.

Today’s approval is the first step in a longer legislative process to expand Medicaid in Utah. Soon officials will begin writing a second, more controversial waiver that limits the amount of money that can be paid to individuals with Medicaid coverage, known as a per capita cap waiver. Health care advocates in Utah have said they are considering litigation to counteract that proposal.

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