Tuesday, a Republican caucus meeting in the state capitol failed to find enough votes to put forward UtahAccess+, the current Medicaid expansion plan, to the legislature. The proposal’s defeat came as a disappointment to House and Senate Democrats.
Minority Leader and Salt Lake City Democratic Rep. Brian King said that Republican House Speaker Greg Hughes ensured that UtahAccess+ would not see the light of day by instituting new voting procedures.
“The Speaker had said that he was not going to consider bringing any plan for Medicaid expansion to the floor of the House unless 38 Republicans agreed to it,” King said. “What he was saying is, ‘We’re not going to pass unless and until the Democrats are irrelevant,’ basically.”
King said that, despite problems with UtahAccess+, there is still bipartisan support for Medicaid expansion.
“The funding mechanism for UtahAccess+ really brought a lot of opposition out from providers who were unhappy about the licensing fee for physicians and other medical professionals. I quite honestly could understand their point, I didn’t think that was a very good funding mechanism,” he said. “But, when we had Medicaid expansion that we were considering in the last session, that was something the Democrats supported and I think it had substantial Republican support, too.”
With its own Medicaid plan, Utah would gain more flexibility in implementation while bearing more of the cost that’s shared with the federal government. King said that the next challenge will be to convince his Republican colleagues to accept the federal government’s expansion terms.
“The federal government has shown no inclination, despite being asked by many other states, to cut back the limit of the Medicaid expansion population,” he said. “If we want to expand just up to 100 percent [of the Federal Poverty Line], that would cause us to lose a very favorable match rate; if we go to just 100 percent, we’ll end up paying 30 percent of the costs and if we stay at 138 percent we’ll get over 90 percent over the next five years. The biggest obstacle, I think, is convincing our Republican colleagues that the fiscally smart thing to do is to go with the federal framework.”
King and other Democrats will hold a town hall to discuss the issue on Thursday at the Salt Lake City Public Library.
