Health officials to examine costs, savings of Medicaid expansion

Published: Thursday, Dec. 13 2012 5:45 p.m. MST

The next six weeks are going to be busy for an out-of-state consulting firm hired to help Utah officials determine whether to expand Medicaid.

Associated Press

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SALT LAKE CITY — The next six weeks are going to be busy for an out-of-state consulting firm hired to help Utah officials determine whether to expand Medicaid.

While numbers, statistics and finances will make up the majority of the resulting report, Utah Department of Health Director Dr. David Patton said "it's people that we're talking about."

And that was made even more clear by comments gathered Thursday during a public forum at state health department offices, to kick off the study.

"I would be dead without Medicaid," said Kris Osborn, who suffers from epilepsy and various other health problems. She said the assurance of having health care coverage has played a big part in her life, allowing her privileges that are denied to many of her friends.

As the state's first director of the Children's Health Insurance Program, Chad Westover, now president at Molina Healthcare of Utah, said he's seen what happens in the lives of individuals with health insurance and without.

"An efficient system of care makes a lot of difference," he said, pleading with Patton to expand Medicaid to include more individuals who don't have access to coverage as the program exists.

Utah Gov. Gary Herbert must decide by Friday whether the state will implement a full expansion, which could include households with annual incomes up to 133 percent of the Federal Poverty Level. The expansion is required by the Affordable Care Act if states wish to receive full federal reimbursement for the the first three years following initial expansion in 2014.

The U.S. Department of Health and Human Services has said 100 percent reimbursement won't come without full expansion of the program, as Medicaid expansion was meant to act in tandem with the rest of the Affordable Care Act, providing coverage options to more Americans.

Boston-based Public Consulting Group intends to gather relevant information, including current and future enrollment data, annual costs and savings potential, and more, to determine the economic impact an expansion might yield.

Its report will be completed before the start of the 2013 legislative session, giving lawmakers information as they move forward with policymaking on the issue.

The influx of people who suddenly become eligible for Medicaid coverage or leave their current insurance situation for a less expensive government-funded program could cripple the current system, said Christian Jones, a senior consultant on the project. Or it could result in a savings if the numbers are tallied correctly and result in higher federal payback.

Utah Hospital Association President Rod Betit said he supports the expansion, even though hospitals throughout the state stand to lose $150 million a year as a result. He said, however, that the program needs to make a lot of changes for it to work.

The current base of primary care providers and medical research is not large enough to support widespread expansion, Betit said.

Dr. Ray Ward, a private practice owner and Medicaid provider, said that while money is an important issue to consider, a bigger benefit is increased health in the community, even lives saved.

"There's a lot of us who do what we do to help people out," said Mike Johnson, co-owner at Trinity Care Center, which primarily treats patients who are uninsured or covered by Medicaid. He said many premiums go unpaid, and are a risk to his business.

Johnson said a government-funded program should be "all about making it so people can survive through difficult times."

Patton said the timeline for the study is tight, but comments are welcome for the next several weeks. The report is expected to be completed by mid-to-late January.

E-mail: wleonard@desnews.com, Twitter: wendyleonards

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