We want the health care dollars brought back to the state. We think we can control those better. —Sen. Stuart Adams, R-Clearfield
SALT LAKE CITY – A Senate committee endorsed a bill that would allow the state to opt out of federal health care reform laws, despite warnings the proposal is based on "fuzzy math" and could create an unintended state bureaucracy.
The Senate Workforce Services, Community and Economic Development Committee voted 4-2 Thursday to forward SB208 to the Utah Senate for its consideration. The legislation, sponsored by Sen. Stuart Adams, R-Clearfield, would permit the state to enter an interstate Healthcare Compact. Under the compact, the state would assume the federal funding for and oversight of programs such as Medicare, Medicaid and the Children's Health Insurance Program or CHIP.
The thinking, Adams said, is the state could do a better job of administering the programs and that moving the programs closer to the people would save money that could be funneled into patient benefits and provider reimbursements.
"We want the health care dollars brought back to the state. We think we can control those better," Adams said, explaining that the compact would require congressional approval.
Paul Mero, president of The Sutherland Institute, a conservative Utah think tank, spoke in favor of the bill, as did an officer of the Utah Eagle Forum.
Mero said naysayers frame their arguments in terms of what the health care landscape looks like now.
"I would prefer to have the innovators inform me what change looks like," he said. "This is a bold idea, clearly. We feel it's a really innovative public policy."
But others said the projected savings under the compact rely on "fuzzy math."
The state would receive federal funding for healthcare programs based on federal appropriations for 2010. More money would be appropriated to accommodate population growth. Payments to member states would be adjusted for inflation, using changes in the gross domestic product as a guide.
"This is the fuzzy math we're having trouble with," said Jason Cooke, Medicaid policy director of the Utah Health Policy Project. "There's a difference in the inflation factor in the bill and inflation in the medical field generally."
While Congress would have to agree to the creation of the compact, Cooke urged Utah lawmakers not to view SB208 as a message bill.
"If you heard it's a message bill, it's not. It's bad public policy."
David Gessel of the Utah Hospital Association urged committee members to be careful what they ask for under SB208.
If the state received $2.3 billion for health care programs, "you're going to have a whole new bureaucracy in this state."
Given the escalating costs of health care nationwide, the federal government might just want to hand off the programs to the states. They might view it, "This is great. I can solve the federal budget problem by offloading this on the states."
Four states have passed legislation to become part of the compact, Texas, Oklahoma, Missouri and Georgia.
The governors of two other states have vetoed the legislation.