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Dan Liljenquist: Utah's Medicaid program will save state billions

Published: Thursday, Jan. 17 2013 12:00 a.m. MST

With all of the bad news that comes out of Washington, it is easy to overlook the things that are going well right here at home. Utah continues to innovate, creatively addressing the seemingly intractable political issues of our time. This month marks a specific policy milestone that has been largely overlooked.

After nearly three years of work, Utah's Department of Health launched a new managed Medicaid program. This program will save taxpayers $2.5 billion over the next seven years while ensuring the same or better health outcomes for Medicaid recipients. It is a singular achievement, and is an example of how government is supposed to work.

Over the last decade, state Medicaid costs grew at three times the rate of the rest of the state budget. In 2010, Medicaid's cost growth crowded out public education spending directly for the first time. By 2020, Medicaid cost growth was expected to consume up to 46 percent of Utah's general fund, up from around 20 percent in 2010. It became painfully clear to everyone involved with the Medicaid program that we had to figure out how to reform Medicaid or it would sink us.

In April of 2010, a few friends and I formed an informal Medicaid reform working-group comprised of key leaders from the Legislature, the Utah Department of Health, Gov. Gary Herbert's office and the medical provider community. Every Wednesday we would meet at the State Capitol and dive into the details of the Medicaid program. By July we had identified the factors contributing to exploding Medicaid costs. By September we had developed a framework for reform that would address those factors. By December we had pressure tested, revised and validated our reform ideas with the broader Medicaid community (advocates, hospitals, doctors, etc.). By the time we introduced the Medicaid reform legislation (SB 180) in February of 2011, we had met with every member of the Legislature, both Republican and Democrat, to address any concerns they might have about the reforms. On March 9, 2011, the Utah Legislature passed SB 180 unanimously, and Herbert signed the bill in a small bill signing ceremony 12 days later.

Once the Medicaid reform legislation was codified in statute, the Department of Health began implementing the reforms. David Patton, the executive director of Utah's Department of Health, Michael Hales, Utah's Medicaid Director, and their capable staff worked closely with the Medicaid provider and advocacy communities to flesh out the details of the new Medicaid program. At the same time, they expertly negotiated with the federal Department of Health and Human Services for the necessary approvals to implement our reforms.

Developing the new Medicaid provider contract fell to Emma Chacon and her staff who worked impossible hours under intense pressure to issue contracts that were consistent with the reform legislation. It was a herculean effort by the Utah Department of Health that the vast majority of Utahns may never hear about. Our Medicaid reforms went live this month, and runaway Medicaid spending in the years to come will not crush Utah.

The issues we face as states and as a nation are not partisan issues. They are not Democrat vs. Republican issues. They are not executive branch vs. legislative branch issues. They are reality issues. We are served best when our political leaders recognize these facts, move past partisanship, and work together to build lasting reforms. Our experience in Utah shows it can be done.

Dan Liljenquist is a former state senator and U.S. Senate candidate.

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