We have no good options that I consider good in this arena. I think this is best of the bad options before us. —Sen. Daniel Thatcher, R-West Valley City
SALT LAKE CITY — The Utah Senate passed a partial Medicaid expansion plan Monday that also gives Gov. Gary Herbert the ability to seek a federal block grant to pay for the proposal he rolled out last month.
But majority Republican leaders in the House won't consider the bill, meaning lawmakers won't have a united approach to deal with the issue before the 2014 Legislature ends Thursday.
"I don't intend to debate this bill on the House floor," said House Speaker Becky Lockhart, R-Provo.
Sen. Brian Shiozawa, R-Cottonwood Heights, amended his SB251 to allow the governor to negotiate with Washington, D.C., but maintain legislative oversight of any Medicaid plan.
The Senate passed the bill 19-6 and sent it to the House.
Herbert's Healthy Utah plan would seek a block grant from the federal government to cover about the same number of needy Utahns as accepting the full expansion of Medicaid offered under the Affordable Care Act, also known as Obamacare.
Senate President Wayne Niederhauser, R-Sandy, said the bill allows the governor to "work his magic" in Washington and "come back to us and hopefully have a good result."
Federal officials last week rejected South Dakota's request for a waiver to fund a partial Medicaid expansion program.
Majority Republicans in the House have spurned any plan that takes federal money and seem prepared to do nothing this session. They did not take a position on Shiozawa's bill.
Lockhart said Herbert doesn't need the Legislature's blessing to talk to the White House.
"Absolutely, absolutely, the executive branch has full authority to negotiate with the Obama administration whenever they would like. It appears that they have been doing so and probably would continue to do so with or without any permission," she said.
Herbert has talked about Medicaid with federal officials on recent trips to Washington.
Instead of receiving Medicaid, the estimated 111,000 Utahns earning less than $15,500 a year would each pay about $420 a year toward private insurance and medical expenses under the governor's proposal.
The plan has a $258 million price tag for the first year of what Herbert said would be a three-year pilot program. Legislative staff members have estimated that more than $500 million is available annually for the full Medicaid expansion.
Shiozawa's plan would help only those earning less than 100 percent of the federal poverty level. The estimated 54,000 Utahns in that category don't qualify for federal health care subsidies.
"We have no options that I consider good in this arena," said Sen. Daniel Thatcher, R-West Valley City, before voting for the bill. "I think this is best of the bad options before us."
Democrats tried unsuccessfully to put Sen. Gene Davis' proposal for full Medicaid expansion into Shiozawa's bill. The Salt Lake City Democrat said Utah is losing $4 million a month by not expanding Medicaid.
"It just provides full health care. No games," Davis said.
Sen. Jim Dabakis, D-Salt Lake City, said it's "foolhardy" to send state tax dollars to Washington and not accept them back for Medicaid expansion.
"It would be a great shame to turn down this money over ideology," he said.
While Lockhart said the House would not take up the Senate's version of dealing with Medicaid, the House passed its own bill 60-12 on Monday.
HB401, sponsored by Rep. Jim Dunnigan, R-Taylorsville, was amended to remove the Access Utah plan backed by Lockhart. The plan would have used $35 million in state funds, along with matching federal dollars, to provide limited coverage to the neediest Utahns.
Now the bill only directs the state's Health System Reform Task Force to study the issue of Medicaid expansion during the legislative interim and report back to lawmakers by the end of November. Dunnigan, who is chairman of the task force, said that includes reviewing the proposals that surfaced this session.
House Minority Assistant Whip Rebecca Chavez-Houck, D-Salt Lake City, a member of the task force, said Medicaid expansion has already been studied for much of the past year.
She expressed concern for those Utahns "left in the wake" by the inaction on the issue.
"I wish we could have come to a resolution," Chavez-Houck said.
Dunnigan said the bill does not preclude any solution to Medicaid expansion.
"What this does do is give the Legislature a mechanism to continue to work on this," he said.
Lawmakers have discussed coming back for a special session or even waiting until next year to deal with Medicaid.
Niederhauser said the human aspect of providing insurance coverage for needy Utahns is "very compelling" but that it's important for the state to make the right decision, whether it takes a few months or a year.
Contributing: Lisa Riley Roche