Medicaid has been an integral part of Utah’s social safety net for more than 40 years. While we in Salt Lake County government are concerned about the general well-being of all county residents, we have a unique legal requirement for public and behavioral health. Issues such as mental illness and drug and alcohol abuse often bring individuals into contact with our criminal justice system. Salt Lake County also administers law enforcement and the jail. We are concerned with the revolving door of people cycling in and out of our jail, as well as the Utah State Prison, many of whom end up there due to mental health or substance abuse issues.
With proper treatment, many of these individuals have a chance at successfully returning to our community, becoming productive members of society and not repeating their crimes. That’s why Salt Lake County has made the most significant investment of any county in Utah in innovative programs and services, so that we can deliver appropriate and compassionate care while also being frugal with taxpayer dollars.
Under the health care reform law — the Affordable Care Act (ACA) — the federal government now funds many behavioral health and criminal justice programs through Medicaid. The U.S. Supreme Court ruled — when it upheld the constitutionality of the ACA — that it was optional for states to expand Medicaid.
Utah has been debating whether and how to do so, but in the meantime, Salt Lake County must continue to serve those for whom we are responsible. We’ve used some one-time funds to bridge a looming budget gap as increasing numbers of low-income people — with no health insurance option — seek treatment. But in January 2015, we will have run out of options and will be left with no choice but to impose significant cuts to our contract prevention and treatment providers of almost 12 percent. That would leave 3,200 clients — people struggling with mental illness or substance abuse — out in the cold.
Mental illness and drug and alcohol abuse don’t discriminate by age, gender, education or economic background. Chances are that all of us have a family member, friend or work colleague who has been affected and who could lose access to health care that is critical to recovery. Behavioral health professionals say we’ve made great progress in treating these issues and helping people get back on their feet, but access to care is a critical first step.
We support Gov. Gary Herbert’s plan to mend the hole in Utah’s health care safety net. Dubbed the “Healthy Utah” plan, it allows Utah to use its hundreds of millions of federal health care tax dollars to cover more than 110,000 low-income Utahns through the competitive private market. The plan is fiscally sound, allows for cost containment and lets family members enroll in the same plan. It keeps Utah tax dollars here in Utah.
Healthy Utah would give us the best opportunity to stop the cycle of people in and out of jail by ensuring effective substance abuse and mental health treatment. It’s the right thing to do — for our uninsured residents and for our county budget.
A recent Brigham Young University poll showed that 76 percent of Utah voters support using federal funds to cover the health insurance needs of more than 110,000 poor and uninsured in our state. Republican and Democratic elected officials here in Salt Lake County are putting partisanship aside in favor of the governor’s sensible plan to help our neediest residents while recouping Utah tax dollars now flowing to Washington, D.C. We respectfully ask the Utah Legislature to meet and act soon to solve this and show that, while we didn’t create this problem, together we can fix it.
Ben McAdams is Salt Lake County mayor. Sam Granato and Aimee Winder Newton are Salt Lake County Council members.
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