Utah is one of five states left to make a decision on the expansion option. Other states are projecting savings and a boon to the health care workforce with the expansion, which is set to take effect in January 2014 for states that have opted in, and some have worked with the U.S. Department of Health and Human Services to achieve more flexibility and come up with their own plans of action — something Gov. Gary Herbert has also been seeking, with continued correspondence with officials in Washington, D.C.
Whether to expand Medicaid in Utah is Herbert's decision alone to make, although HB391 — the result of a compromise made in the late hours of the legislative session — asks that he consider economic projections as well as public input, among other things.
In the weeks and months to come, Herbert will likely make available the results of a Utah Department of Health-commissioned impact study on expanding the partially federally funded health insurance program to more Utahns, specifically those who are low-income and currently uninsured. That report was delayed several times since it was initially promised prior to the start of the session.
The governor has also said he will convene a committee of state leaders and stakeholders to weigh public input and ultimately do what is best for the state, those in need of care and the bottom line.
Local advocates for low-income people are looking forward to being part of that discussion "to find the best path forward for Utah," said Matt Slonaker, Medicaid policy and collaborations director at Utah Health Policy Project.
Slonaker said legislative action that encouraged a team approach with the governor was "a positive step in the right direction for the state."
More than 130,000 Utahns stand to gain coverage with the expansion, but it could end up costing the state millions in the end, especially if federal moneys suddenly become unavailable, as they are not guaranteed.
And even though no decision was made, Medicaid expansion was the hottest health topic on the hill throughout the session, with many people appearing to testify of their need for coverage.
Rep. Todd Weiler, R-Woods Cross, estimated that 95 percent of all correspondence he's had on the issue has been in favor of expansion, although having endured countless hours of testimony, committee meetings and public hearings in the past year, he said the choice is a tough one to make.
"I think we're getting close," Weiler said.
In order to make coverage available to the expanded population by the January 2014 federal implementation date, a decision needs to be made in Utah before summer's end. The option, however, is on the table indefinitely. Federal funding rates decrease after the first three years, however.
The problem of poor air quality in the state made headlines throughout the session, but lawmakers didn't make much headway.
More than 200 doctors urged Herbert to declare a public health emergency in January, the same month the Utah Legislature got under way. Advocates for cleaner air, however, say lawmakers continued to ignore the public health impacts of Utah's dirty air by failing to pass any meaningful laws that could have addressed the issue.
Elevated levels of fine particle pollution have been linked to increased visits to hospital emergency rooms for incidences of stroke, cardiac arrest and accelerated onset of dementia in elderly women. Asthma sufferers also continue to bear the brunt of suffocating inversions that landed the state on the U.S. Environmental Protection Agency's list for the dirtiest air in the country this year.
Yet Utah's Republican legislators snubbed several bills dealing with the matter brought forward by a group of Democrats.
Contributing: Amy Joi O'Donoghue
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