SALT LAKE CITY — Utah's House speaker has once again put his foot down when it comes to Medicaid expansion, but Utahns are still asking for broader access than what one popular bill would provide.
House Majority Leader Jim Dunnigan, R-Kearns, has proposed HB437 to expand coverage to the poorest in Utah, specifically childless adults who are chronically homeless and who find themselves in and out of the justice system for various reasons, but never get proper treatment for recurrent mental health issues because of a lack of access to proper health care.
Dunnigan has said it is a starting point for the state, one that will yield helpful numbers to estimate further growth and potential expansion.
House Speaker Greg Hughes, R-Draper, who supports Dunnigan's bill, said Wednesday there's no room for compromise.
"If we can get it accomplished, it will be that bill," he said. "Politics is the art of the possible. I think what's possible is what Rep. Dunnigan has been working on. I think that stands as our best chance of doing something on that front."
Hughes said the state can't afford the bill calling for Utah to accept full Medicaid expansion that was approved by a Senate committee Tuesday. SB77, sponsored by Senate Minority Leader Gene Davis, D-Salt Lake City, has a $50 million price tag but covers more people and leverages more federal funds than Dunnigan's bill.
Josh Kanter, founder of the Alliance for a Better Utah, said Wednesday it isn't a matter of being able to afford expansion, calling it a "moral imperative."
"Utah can afford this," he said. "This is an issue of will. This is an issue of ethics. This is a matter of priorities."
Kanter said it has been 785 days since Utah could have expanded Medicaid, joining in on a federally funded provision of the Affordable Care Act that took effect in 2014.
"How is it possible we have yet to do it?" he asked.
Utah is among a handful of states that have not yet decided what to do in the wake of Obamacare provisions. Many lawmakers have expressed a desire to wait out the upcoming presidential election or see how promised funding plays out for other states.
"You'd have to show me how you could pay. It's a lot of money," Hughes said.
Using traditional Medicaid coverage as Dunnigan proposes gives the state more control over spending and "more certainty," the speaker said.
Hughes said he did not feel the Senate was attempting to push the House to take action on Medicaid expansion by sending SB77 to the floor.
"I don't think there's any pressure. I think they're just going through their course of business," he said. "And maybe they just want a broader debate. We'll see."
Senate President Wayne Niederhauser, R-Sandy, said he had not seen Dunnigan's bill as of Wednesday afternoon but had been briefed on its contents. He said it has a good chance to pass in the Senate.
Despite positions of leadership, Rep. Raymond Ward, R-Bountiful, encouraged Utahns to keep sharing their stories of struggle.
"It's been such a long battle," he said. "We will get it."
Ward is backing HB302, a bill akin to the governor's ill-fated Healthy Utah plan introduced last year. He said the problem of a growing number of uninsured Utahns "is not going to go away."
Sen. Brian Shiozawa, R-Cottonwood Heights, said lawmakers have heard and will continue to hear the pleas from Utah's uninsured or underinsured. He's hoping "we'll walk away with something meaningful for our citizens who so badly need it."
"I just want to know what's wrong with my body," said 19-year-old Jose Chacon.
He complained of chronic back pain, residual effects of a recent concussion and recurring digestive issues. The Salt Lake Community College student said asking relatives for money is out of the question, as most of them are "working class just like me."
Chacon's health has been an issue from birth, as he was born prematurely to a teenage mother. His own limited, state-sponsored coverage plan has fallen short in offering him a positive diagnosis or course options for further treatment.
Chacon was one of nearly a dozen to speak Wednesday in favor of state lawmakers making any move on Medicaid expansion to help the tens of thousands who live without health insurance.
At the halfway point in the legislative session, Kanter said, "it's time."
"I have worked so hard to get out of that life," Chacon said, adding that watching his mother deal with prescription drug addiction and an abusive relationship was more than sobering as a youth.
Chacon's mother died of a drug overdose when he was in high school, he said.
"It's frustrating to work so hard but then not have access to health care and then to have issues with my health threatening to hold me back," Chacon said.
Much of the discussion surrounding a variety of expansion bills that have come and gone over the years has been regarding projected costs associated with expanding benefits to cover an unexpected number of Utahns, as Hughes noted.
Ward said those numbers have shifted the focus from where it should be — on the lives of Utahns, an estimated 430 of whom have died while lawmakers deliberate.
But Ward said he believes the stories, like that of Chacon and others that continue to be told on the Hill, "will eventually change their minds."
"So don't give up," he said.
Contributing: Lisa Riley Roche, Dennis Romboy