Gov. Gary Herbert: Caring for the poor the Utah way, with responsibility and flexibility

By Gary Herbert

For the Deseret News

Published: Friday, Feb. 28 2014 6:28 p.m. MST

Utah Gov. Gary Herbert makes remarks during Medicaid expansion news conference in this Thursday, Feb. 27, 2014 file photo, in Salt Lake City. Herbert announced he wants to reject a full Medicaid expansion, and instead seek federal dollars to cover the poor. Herbert made the announcement Thursday afternoon, saying the state has an obligation to cover the poor by plugging a hole in the safety net.

Rick Bowmer, Associated Press

Enlarge photo»

When it comes to taking care of Utahns living in poverty, Utah can craft a better solution than the federal government.

Utah families and businesses will continue to pay hundreds of millions of dollars in federal taxes to support expanding health care coverage for the most needy in our communities. My job as governor is to make sure Utahns get the full benefit from their taxes. Whether a tax is federal, state or local, it comes from the same source: your pocket.

The Affordable Care Act created a gaping hole in Utah's safety net. We did not create this problem, but we must solve it and ensure the poorest Utahns have access to appropriate health care. If we do nothing, uncompensated care will continue to shift tens of millions of dollars to consumers and businesses in the form of higher costs of private health insurance and Obamacare penalties.

Both chambers of our state Legislature rightly recognize doing nothing is not an option and accepting Utah taxpayer money back from the federal government in some form is an important element in solving the challenge we face. Since doing nothing is not an option, the question is: what should we do? I believe ultimately we need a plan of action that demands individual responsibility, supports private markets, maximizes flexibility and respects the taxpayer.

Utah should not expand the federal Medicaid program. Instead, I am prepared to pursue a block grant from the federal government to bring Utah taxpayer dollars back to our state to be used in a distinctly Utah way to fulfill our responsibility to care for the poorest among us.

Members of both the House and Senate have expressed support for flexibility under a block grant. I agree, and there is no reason to wait. We should immediately work toward a State Innovations waiver that will provide the flexibility of a block grant to support a three-year pilot program that I call "Healthy Utah.”

During this three-year pilot program, the state will use the block-grant funds to help Utahns making less than $15,500 annually by providing assistance to pay for health insurance in private markets. The amount of assistance will depend on the recipient’s ability to work, household income, access to employer or family health insurance, and individual health care needs.

Participants in the plan will help pay for the cost of their care through co-payments. In addition, those with slightly higher incomes will be required to pay 2 percent of their monthly income to help pay for the insurance premiums.

Family life these days is challenging enough without trying to manage health care through multiple networks with multiple sets of rules. So parents with children on Medicaid will be given the option to put their entire family on their private-market plan.

We will also require the Utah Department of Health to closely monitor the pilot program and report to both the Governor's Office and the Legislature. At the end of the three years, this will allow us to evaluate how to proceed based on the health needs of the participants, the ability and willingness of the federal government to live up to its commitments, and the impact to our state budget.

The block grant from the federal government will cover fully the funding needs for the pilot program, so no additional state money will be required. We will also be able to reduce or close redundant state programs, and from those savings, we will be able to cover the administrative costs of this program.

By getting our money back from the federal government, we can use scarce state funds in other important areas such as expanding Utah’s autism pilot program and funding other important education initiatives.

I have long advocated that in Utah we can do more with less if Washington, D.C., would just block grant the money, remove the strings and give us maximum flexibility. This is our opportunity to prove that point and to create a healthy Utah.

Gary R. Herbert is the 17th and current governor of the state of Utah.

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