Utah won't be the first state to expand Medicaid, but when push comes to shove, at the end of the day, we probably won't be the last either. As each state goes ahead and expands, Utah will probably end up doing that at some point because we want our share of the pie. —Senate President Wayne Niederhauser, R-Sandy
SALT LAKE CITY — A bill aiming to ban Medicaid expansion in Utah passed through the state’s House of Representatives on Monday.
The preliminary numbers don’t add up to a sound financial decision for the state, said the bill’s sponsor, Rep. Jacob Anderegg, R-Orem. He said he also doesn’t trust that federal money will be available to cover the expansion, which is an optional portion of the Patient Protection and Affordable Care Act.
“It’s just not sustainable,” Anderegg said, instead proposing that the state symbol of the “industrious” beehive be considered for possible alternatives. “This false promise and this false hope can be answered in us, our most important asset — our people.”
Rep. Mike Kennedy, R-Alpine, said that as a family practice doctor, he would answer the call of his ecclesiastical leaders, if need be, to provide charity care for members of his community. He said the state similarly sends thousands of LDS missionaries into the world to perform service.
“My vision is a vision of people, county by county, throughout the state, stepping up, hearing the call to action and stepping up to serve the least of these our brethren,” Anderegg said, quoting biblical scripture. “We have the power to do this ourselves.”
HB391 made it out of the House with every Democratic representative — and a dozen Republicans — voting against it. It moves to the Senate for further consideration, though leaders there say it won’t last long.
“I think the governor’s the man who has the call on the expansion of Medicaid,” said Senate Majority Assistant Whip Peter Knudson, R-Brigham City. “At this point, I’d prefer not tie his hands and give him whatever latitudes he needs to make his decision, so I’m not in favor of the bill itself.”
Senate President Wayne Niederhauser, R-Sandy, said the Legislature would appropriate the money for expansion, so it needs to work with the governor on the issue.
“Utah won’t be the first state to expand Medicaid, but when push comes to shove, at the end of the day, we probably won’t be the last, either,” he said. “As each state goes ahead and expands, Utah will probably end up doing that at some point because we want our share of the pie. Why wouldn’t you do that?”
Rep. Rebecca Chavez-Houck, D-Salt Lake City, asked her colleagues to consider the hours of testimony offered by Utahns who could benefit from the expansion of Medicaid, which would cover those up to 138 percent of the federal poverty level.
As the sponsor of a separate bill that would have paved the way for Medicaid expansion in Utah, Chavez-Houck said the health care work force would surge locally, and county budgets would rebound from having to spend money on behavioral and mental health care for prison inmates.
None of the costs or benefits have been determined, however, as Medicaid expansion isn’t set to take effect anywhere until January 2014. The decision lies with the governors of each state, and Utah is one of five states yet to make a move in either direction.
Gov. Gary Herbert has been waiting for a Utah Department of Health-commissioned report on projected impacts to the state before he discusses the matter openly. The report has been delayed since before the legislative session began.
Rep. Marie Poulson, D-Cottonwood Heights, said money that would come from the federal government — which would fund 100 percent of the expansion for the first three years and waning participation to 90 percent after that — is “depriving over 131,000 needy Utahns of the opportunity for vital and life-saving health care” that is impossible to provide completely by charitable offerings.
“This bill, for me, is not about sticking it to the man. It is not about making an anti-Obamacare statement or an anti-Affordable Care Act statement,” said Rep. Francis Gibson, R-Mapleton. “This bill is about making fiscally responsible decisions for the generations to come. It is the one part of the law that states were given the ability to decide on their own.”
Utah Democratic Party Executive Director Matt Lyon, however, said the Utah GOP “chose Washington ideology over the practical, reasonable and fiscally responsible policy of expanding Medicaid.”
House Speaker Becky Lockhart, R-Provo, said, "It is a message that a majority, a significant majority of the House, are not in favor of expanding Medicaid."
The bill did not pass with the 50 votes needed for what would be considered a veto-proof majority.
Anderegg emotionally explained his purpose behind the bill, saying he strives to live by words of scripture that encourage mankind to serve each other.
He doesn’t believe the governor should be left to make the decision on the matter alone.
“Mr. Governor, I hope you listen to the voice of the people,” Anderegg said. “Catch my vision and come with me. I am reaching across the aisle. I don’t want to leave people without coverage, but there is a better way. I know there is.”
Contributing: Dennis Romboy, Lisa Riley Roche