Costs, borne mostly on the administrative level, are expected to increase as promised federal reimbursement declines from 100 percent to 90 percent over 10 years. If the match rate changes beyond that, a provision in the law allows states to opt out altogether.
Matt Slonaker, Medicaid policy and collaborations director for the Utah Health Policy Project, an advocacy group for uninsured Utahns, said he believes the projected enhancement of savings and economic activity of Medicaid expansion would "dwarf" any investment while also providing coverage for more than 100,000 Utahns in need of health care.
"The question of expanding Medicaid is simple," he said. "Do we want to make health care more affordable for Utah workers and their families, or are we going to continue to ask a family that earns $30,000 a year to do the impossible and pay $15,000 for private insurance?"
Committee member and community advocate Pamela Atkinson said she's optimistic that costs would decline over time as people are able to visit the doctor more often.
Her hope is validated by the report's indication that individuals with health care enjoy an increased quality of life and a greater life expectancy by at least a year.
Vaughn Davis, who chairs the consumer advisory board and was a former patient at the charity-based Fourth Street Clinic in Salt Lake City, said, "For many of us, regular health care visits were the first step in moving out of homelessness."
Waiting to get access to Medicaid, he said, leads to some losing unhealthy body parts, but also their dignity "as they slowly become disabled and eligible for Medicaid."
"We just want to be able to see a doctor when we are sick and our only path is with Medicaid," Davis said. "There are no other options for us."
Expanding Medicaid is also projected to save hospitals, clinics, pharmacies and other medical facilities hundreds of thousands of dollars lost each year to unpaid claims.
The report indicates that full expansion would lead to an economic boon, resulting in new jobs in a variety of health and retail sectors and increased tax revenues to state and county governments, which would no longer be required to cover mental health and substance abuse treatment for inmates.
Mandatory expansion would likely generate $516 million in economic impact and create 747 new jobs in the state. Full expansion, beyond mandatory federal requirements, is projected by the consulting group to possibly generate $2.9 billion statewide and create 4,160 new jobs.
The full report, including analyses for each scenario, is available at www.health.utah.gov.
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