Idaho, Wyoming watching Utah's Medicaid expansion efforts

Published: Saturday, April 19 2014 2:35 p.m. MDT

Utah Gov. Gary Herbert makes remarks during Medicaid expansion news conference Thursday, Feb. 27, 2014, in Salt Lake City.

Rick Bowmer, Associated Press

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SALT LAKE CITY — Gov. Gary Herbert's proposed alternative to Medicaid expansion is getting attention from neighboring states that initially rejected the coverage available under President Barack Obama's health care law.

Herbert is in "active conversations" with fellow Republican governors who are rethinking whether to accept Medicaid expansion, Utah Department of Health Executive Director David Patton said.

"I know Idaho has said no. Wyoming has said no. But they're both talking to the governor, saying, 'What are you guys doing that might be a good idea?'" Patton said.

Idaho is "very interested in what you all are doing and what the governor is proposing over there," Jon Hanian, spokesman for Idaho Gov. C.L. "Butch" Otter, said of Herbert's "Healthy Utah" plan.

"That's more a function where we're more simpatico with the approach you all have taken, not only politically, but regionally and philosophically," Hanian said. "We're very interested in picking and choosing what may work, not reinventing the wheel."

Earlier this month, Otter asked the Idaho Department of Health and Welfare to take another look at Medicaid expansion, including what other states are doing to cover low-income residents under the Affordable Care Act, and report back in September.

Hanian said while Otter "firmly believes that he doesn't want to throw more money into a system he believes is crying out for reform," he is reacting to a recommendation from a state task force that Medicaid be expanded.

Last month, the Wyoming Legislature called on Wyoming Gov. Matt Mead to start talking with the federal government about the state's options for Medicaid expansion.

Mead's spokesman, Renny McKay, said Wyoming's governor still doesn't support Medicaid expansion "as it has been brought forward" but now can determine what the state might be allowed to offer as an alternative.

"What the governor has asked the Department of Health to do is watch a few other states closely to see what they have done and what they are proposing," McKay said. "Utah is one of the states they're keeping an eye on."

After a trip to Washington, D.C., this month to pitch his plan to the Obama administration, Herbert told reporters that states should be given control of the funds available for Medicaid expansion.

"The more the states can have the responsiblity of spending the money, they'll find efficiencies," Utah's governor said. "I do believe other states around the country are watching us in a significant way."

Herbert is seeking waivers to use the $258 million available for Medicaid expansion in Utah for a state-run plan offering private health insurance to 111,000 low-income Utahns.

Nearly 60,000 of those Utahns, those earning less than 100 percent of the federal poverty level, do not qualify for any health care coverage subsidies without the expansion.

He wants to require recipients to work and to contribute to the cost of the plan, through making increased co-payments for services and picking up at least part of the premium.

If Utah succeeds in selling the federal government on what's been called a "block grant approach" to Medicaid expansion, Herbert said other states will want to follow the state's example.

With a Democrat in the White House, states led by GOP governors have a special interest, said Piper Su, vice president for health policy at The Advisory Board Company, a Washington-based health care consulting firm.

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