SALT LAKE CITY — On Valentine's Day, Sen. Stuart Adams asked members of the Senate Health and Human Services to postpone a hearing on his bill to allow Utah to join an interstate compact to opt out of federal health care reform laws.

An expert witness from out of state wasn't able to attend the meeting, so the agenda item lingered awaiting further word from the sponsor.

A week later, the Layton Republican asked the full Senate if the bill could be reassigned from the Senate Health and Human Services committee to the Workforce Services, Community and Economic Development committee, a move that raises questions and concerns for some senators and advocates for seniors, the poor and people with disabilities.

When Adams asked the Senate to move the bill, he told his colleagues that both committee chairmen and the Rules chairwoman "indicated this is probably an acceptable move." 

But Sen. Luz Robles, D-Salt Lake, a member of the Senate Health and Human Services committee, opposed the change.

"I'm really concerned. We're dealing with a health care-related bill and it's being moved from Health and Human Services to a completely different committee. We've been waiting for this bill. We actually tabled this bill as a request of the sponsor. We've been waiting to discuss this bill for the last week. I don't think it's appropriate to move it. I'm completely opposed to it."

When Health and Human Services committee member Sen. Patricia Jones, D-Salt Lake, asked Adams to explain why he sought to move the bill, he said, "I've got three bills tomorrow (Wednesday) in the Health and Human Services committee. I think given the time commitment and the number of bills they have, I think it's better heard in Workforce Services."

With a voice vote, the bill was moved. Adams could not be reached for comment on Wednesday.

Some advocates are concerned about the change of venue because members of the Senate Health and Human Services Committee are well-versed in the funding mechanisms of federal health care programs and the health care reform efforts under way in Utah.

"At the very least, the Senate Health and Human Services Committee had enough sense and expertise to know this was a bad idea. They have the deep background to understand it," said Judi Hillman, executive director of the Utah Health Policy Project.

While some on Capitol Hill say the legislation is a message bill, four states — Texas, Oklahoma, Missouri and Georgia — have passed legislation joining the compact. Under SB208, the state also would replace federal programs such as Medicaid and Medicare with a block grant from the federal government. Congress would have to give its approval to the states for the compact to take effect.

"Is the message worth the risk the state is incurring taking this on?" asked Jason Cooke, Medicaid research and policy director for the Utah Health Policy Project.

One the advocates' primary concerns is that the compact says each state's funding will be based on the federal funds spent in their state on health care in 2010.

Unless new state spending covers inflationary costs, benefits and reimbursements to health care providers will suffer.

"Right off the bat, you're providing the same amount of care with less money to do it," Cooke said.

Hillman added, "This is cutting beneath the bone."

Others worry about access to health care. Medicaid and Medicare payments to health care providers are so limited that some physicians already limit the number of patients on federal health programs they accept in their practices.

Dr. Tom Metcalf, a retired pediatrician and longtime advocate for children's health care, said physicians take an oath to do no harm. He said he hopes members of the Workforce Services committee, which is scheduled to hear the bill at 8:30 a.m. in Room 215 of the Senate Building, will apply the same sensibility to SB208 because "real people will be affected by it."

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