Utah Senate Votes to Limit Medicaid Expansion

Feb. 04--Feb. 4--Supporters of a voter-approved measure to fully expand Medicaid rally at the Utah State Capitol last week demanding lawmakers not change the law during the first day of the Utah Legislature. The Senate voted to do just that yesterday, limiting the number of people who would qualify for Medicaid benefits. Rick Bowmer/The Associated Press

The Utah Senate passed a bill Monday that would sharply limit the Medicaid expansion approved by voters in November. The Republican-controlled Senate passed the bill, although a fiscal analysis shows that, if enacted, it would cost state taxpayers an estimated $72 million before expected savings kicked in.

Instead of expanding eligibility for Medicaid to any adult, including single adults without children making 138 percent or less of the federal poverty line (about $16,750 for an individual), the bill would limit beneficiaries to those who make 100 percent of poverty.

The bill, which passed the Senate 22 to 7, now moves to the Utah House, which is also controlled by Republicans.

An analysis by the Utah fiscal office found the state would initially spend more money to cover fewer people because lawmakers' scaled-back version doesn't qualify for increased federal money under President Barack Obama's signature Affordable Care Act.

Currently, Utah covers 30 percent of the cost of Medicaid, with the federal government kicking in the other 70 percent.

Full Medicaid expansion, as specified by the voter-approved Proposition 3, would have increased the federal portion to 90 percent as part of the Affordable Care Act. The referenda passed with 53 percent of the vote in November.

Groups that supported Proposition 3 in November expressed outrage over Monday's Senate action. "This bill is a slap in the face to Utahns who voted for full Medicaid expansion in their state," said Jonathan Schleifer, executive director of the Fairness Project, an advocacy nonprofit that promoted successful Medicaid expansion referenda in Utah as well as Idaho and Nebraska.

Voters in three red states -- Idaho, Nebraska along with Utah -- bucked their own Republican legislatures in November and approved the expansion of Medicaid, extending medical benefits to tens of thousands of low-income residents.

In Utah, it was expected that 150,000 residents would gain access to Medicaid under the voter-approved expansion.

Lawmakers in Idaho and Nebraska also have expressed doubts about how to move forward. Republican lawmakers in Idaho have met to consider restrictions that could delay launch there, according to the Idaho Statesman.

And in Nebraska, Gov. Pete Ricketts, a Republican, wrote on his official website that, should lawmakers move ahead with expansion, the state risks the chance that the federal government won't meet its Medicaid match.

"Expanding Medicaid in Nebraska is a risky proposition for taxpayers not only because of the expense but also because we cannot trust the federal government's long-term financial commitment to state programs," Ricketts wrote.

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