State Medicaid panel faces tough balancing act

Starting this week, the Medicaid Interim Committee of the Utah Legislature begins a comprehensive look at the government program that is intended to provide health care and health-related services to low-income people.

Medicaid is administered by the states but funded by the federal government and the states. One of the greatest challenges facing the states is the federal government has become increasingly stingy with its share of funding. Either states fund an increasing share of the programs or they cut them. Neither is a particularly comfortable place for public policymakers because the people who receive these services are desperately poor. They simply can't afford services that aren't covered by Medicaid, such as dental care or vision exams. They do without, to their peril.

The Utah Legislature has taken a lot of grief in recent weeks for refusing to consider, in special session, a $2 million appropriation for emergency dental coverage for Medicaid recipients. The issue got a lot of coverage because the same day that lawmakers refused to act on the dental issue, they appropriated $15 million for an underground parking structure. Although those funds came out of a different pot of money, the public doesn't much care about the distinctions. The way John Q. Public figures it, it's all taxpayer money, whether it's tax revenue or money the state has borrowed for capital projects.

Now there is a private campaign afoot to provide funding for emergency dental funding. An anonymous donor will give $1 million if a match of another $1 million in contributions can be secured. That money can be matched with federal money, said Pamela Atkinson, a community advocate behind the effort.

Atkinson says she'll know by week's end if the fund raising will come together. If it does, it will make a powerful statement to Utah lawmakers that it is not acceptable to this state that people with emergency dental needs not receive care. But legislators shouldn't think for a minute that this private effort gives them an out. This is a one-time, stop-gap measure. Legislators have to revisit this issue, as well as funding for vision care.

Atkinson said many of the people and businesses she has contacted have been "pleased to be asked." Knowing Pamela as I do, she can make a very compelling case because she intimately understands poverty and the poor.

On the other hand, I can't help but wonder if some Utahns feel as though they've already paid for these services through their taxes. State money is available, but it's a matter of funding priorities and, quite honestly, political gamesmanship.