The governor and the Legislature should do everything possible to keep as many of Utah’s ACA tax dollars here in Utah. Expanding Medicaid to Utah’s neediest adults is the most straightforward way to accomplish this. Expanded Medicaid coverage will not only satisfy what seems to us a vital humanitarian obligation, but analyses we trust suggest the potential for Medicaid expansion to act as an investment in improved health outcomes. Properly administered, Medicaid expansion should increase access to preventive and primary care, thereby driving down uncompensated costs for costly emergency room visits and crisis intervention.
Mending the safety net in a timely and sensible way will require giving the governor some flexibility. In a recent meeting with our editorial board, the governor has publicly committed to pressing for a variety of sensible modifications such as work requirements, allowing subsidization of private plans and so-called “circuit breaker” provisions that would allow the state to opt-out if federal commitments changed.
Given the fiscal irresponsibility of Washington, we sympathize with those who have a principled opposition to any expansion of federal powers, especially under the banner of Obamacare. But the patchwork of health care programs for the poor that is called Medicaid has been an integral part of Utah’s social safety net for more than four decades. A modest expansion of this state-administered program with negotiated improvements to meet the unmet needs of the poor would be a far cry from the excesses and ineptitudes of the novel elements in the new health care law.
Utahns pay both state and federal taxes, and they benefit from federal cost-sharing in myriad ways as they grow transportation infrastructure, improve public safety and expand schools and universities. There are instances when the restrictions attached to federal funds may outweigh their benefit and the state should deny them. However, as long as Utahns are required to shoulder hundreds of millions of dollars of new Obamacare taxes, rejecting a cost-sharing plan that address the unmet health needs of the poor does not make sense. Given these concerns, the Legislature should empower the governor to negotiate a reasonable expansion of the state’s Medicaid program.