Frank Pignanelli & LaVarr Webb: A few public policy issues that need more attention

Published: Sunday, Sept. 30 2012 12:00 a.m. MDT

In this March 23, 2010 file photo, President Barack Obama signs the health care bill in the East Room of the White House in Washington.

Associated Press

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The political horse races are becoming a little tiresome, even for us. For a change of pace, here are some key public policy issues that need more attention.

Medicaid expansion is shaping up as a hot issue in Utah and other states. Should Utah expand Medicaid coverage as outlined in Obamacare?

Webb: Originally, Obamacare would have forced states to significantly expand Medicaid to cover many more people. Thanks to the U.S. Supreme Court, expansion is now optional. But it's still tempting because the federal government will pay 100 percent of expansion costs for a few years and most of the costs for some time thereafter.

However, even with the big federal subsidies, Utah state budgeters are skeptical about expansion. Medicaid costs are burgeoning out of control even without expansion. Even with big federal subsidies, the state's additional share, over time, will be hundreds of millions of dollars. What's more, the federal government is flat broke, borrowing $4 for every $10 it spends. State leaders wonder how long the federal largesse can continue.

It sounds great to cover tens of thousands of more people with health insurance through Medicaid. Health care advocates will make a big push for expansion. But legislators are going to seriously question the long-term cost.

Pignanelli: "Bureaucracy gives birth to itself and then expects maternity benefits."— Dale Dauten. Many Utahns love to attack "liberal government programs," while they or loved ones reap the benefits. Almost 30 percent of all Utah maternity deliveries are paid by the state through Medicaid (a minority are undocumented workers). Over 26 percent of deliveries in Utah County — especially married BYU and UVU couples — and more than one third of births in Davis County are paid by other Utahns. (I relish throwing these facts at my tea party friends).

Many Medicaid recipients are seniors in care centers and the children of working families. Are we really going to throw the disabled elderly out on the streets? Should we punish the children of struggling households by excluding them from basic health care? The numbers are so huge that every Utahn has a family member or friend who is receiving Medicaid assistance.

The bigger question we must confront is what burden taxpayers should undertake for the greater good. These inquiries are important because they will lead to greater efficiencies and quality of care to the people who need it.

Will Utah ever escape the bottom of the barrel in per pupil public education funding?

Webb: Given Utah's many children and limited tax base (see below), Utah will never approach even the average national expenditure per pupil. But hope does exist for improved funding. The business-led Prosperity 2020 program, along with Education First, an education advocacy PAC also led by business leaders, are having a real impact. The governor and many state legislators say education funding is their top priority. Energy development in school trust lands will provide a big shot of funding over the long term.

Lawmakers will certainly fund growth, but they won't throw additional money at the same old system. Meaningful education reform must accompany higher funding. So the task is for educators, legislators and business leaders to agree on substantive reforms that really will improve public education, and then provide adequate funding.

Pignanelli: The community organizations that LaVarr highlights are to be commended for their sincere interest in improving the public education system. You can call me cynical (I prefer "truth broker"), but their attempts to increase resources for Utah schools in the next legislative session will have a limited impact. To raise Utah from 51st to even 40th in rankings will require the investment of hundreds of millions of additional dollars. Taxes will need to be raised or major programs axed — actions that the politically sensitive bodies on Capitol Hill will not undertake. This endeavor can only be accomplished through an initiative.

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