Gov. Gary Herbert signed into law a bill amending Utah’s voter-approved Medicaid expansion on Monday, hours after the state Senate passed it and despite criticism from Democrats that it ignores the will of voters.
Following the 22-7 vote , Herbert quickly signed the controversial bill as the state races to get federal approval to start expanding Medicaid to meet an April 1 start date planned for Proposition 3.
“S.B. 96 balances Utah’s sense of compassion and frugality. It provides quality coverage to the same population covered by Proposition 3 in a meaningful, humane and sustainable way,” Herbert wrote.
Voters passed Proposition 3 last November. It expanded Medicaid to people who earn up to 138 percent of the federal poverty level, nearly $17,000 for an individual, and increased the state sales tax by .15 percent.
Republicans changed the bill, which sped through the Legislature, to reflect concerns that the tax hike was insufficient to pay for full Medicaid expansion. The new plan will also create work requirements for some people getting coverage and cap enrollment in the program.
“I think we’re doing the long-term, responsible thing, which we are bound by the Constitution to do,” said Sen. Allen Christensen, R-North Ogden, the sponsor of S.B. 96.
States are allowed to expand Medicaid up to 138 percent of the federal poverty level -- about $17,000 for an individual -- under the Affordable Care Act. Christensen’s proposal scales that back to 100 percent of the poverty level, or about $12,000, while attempting to increase subsidies to Affordable Care Act health plans for those between 100 and 138 percent.
Proposition 3 sought to bring low-income health insurance to 150,000 Utahns. According to the Utah Department of Health an estimated 70,000 - 90,000 Utahns would qualify for Medicaid under the new expansion plan. Approximately 40,000 could get insurance under subsidized ACA plans, capped at two percent of their income.
Health care advocates and citizens blasted members of the legislature over the past two weeks, saying the changes weaken the will of voters and the plan relies on permission from the federal government’s Centers for Medicare and Medicaid Services which could delay or deny implementation.
Statements rolled in on Monday afternoon from groups that supported Proposition 3.
“This bill repeals and replaces Proposition 3, the Medicaid expansion approved by voters,” wrote Laura Polacheck, a spokeswoman for AARP Utah.
“The governor and state legislature have turned their backs on voters and our families in need,” read a statement from Andrew Roberts, a spokesman for Utah Decides.
But some advocates struck a more conciliatory tone, including Matt Slonaker, executive director of the Utah Health Policy Project.
“This bill is not perfect, and there are significant parts of it that we don't support and will work hard to fix. But Governor Herbert, President Adams, and Speaker Wilson have stated that we will have an April 1, 2019 roll out date of coverage,” he wrote. “UHPP, and our partners in the community, should be ready.”