Kristin Murphy, Deseret News
Gov. Gary Herbert isn't backing down from insisting on a work requirement in his Healthy Utah alternative to Medicaid expansion, even though Pennsylvania's governor had to drop the same mandate to win federal approval.

SALT LAKE CITY — Utah Gov. Gary Herbert isn't backing down from insisting on a work requirement in his Healthy Utah alternative to Medicaid expansion, even though Pennsylvania's governor dropped the same mandate to win federal approval.

"We're always keeping an eye on what's happening in other states that are in a similar situation. That said, we're not always reactive," Herbert spokesman Marty Carpenter said Tuesday. "It's still a very important element of the deal to the governor."

Last week, the Obama administration announced it had signed off on Pennsylvania Gov. Tom Corbett's plan to use the money available under the Affordable Care Act to provide health care coverage to low-income uninsured residents.

Corbett's Healthy PA plan is close to what fellow Republican Herbert has proposed, except that the Pennsylvania governor dropped a requirement that able-bodied recipients look for a job.

Herbert is scheduled to travel to Washington, D.C., to meet on Sept. 9 with U.S. Health and Human Services Secretary Sylvia Burwell in hopes of reaching a deal on spending the nearly $300 million available to Utah.

The Healthy Utah plan would still need to be approved by the Utah Legislature. Herbert has said he would like to call lawmakers into special session this fall to consider the plan.

Both Senate President Wayne Niederhauser, R-Sandy, and Rep. Jim Dunnigan, R-Taylorsville, were invited to go to Washington with the governor to meet with Burwell, Carpenter said. Only Dunnigan is expected to attend.

"People just need to remember as we're negotiating this, it's something we're sort of doing on two fronts," Carpenter said. "I think that's to some extent what gets lost in it."

Herbert needs to win over both the Democratic administration in Washington and the GOP lawmakers in Utah who have balked at backing anything related to President Barack Obama's signature health reform law.

The work requirement is "part of the calculations that need to be made" to advance the Healthy Utah plan on both fronts, Carpenter said. He said the governor sees asking people getting help buying insurance to work is a "right principle."

University of Utah political science professor Matthew Burbank said the work requirement will appeal to lawmakers especially since it's something the Obama administration doesn't want.

Burbank said Corbett was in a different situation politically in Pennsylvania because he faces strong Democratic opposition in his bid for re-election in November and pressure to wrap up the Medicaid issue.

Corbett "wasn't going to be in a position to fight to the death on the work requirement," Burbank said, while Herbert "is looking at this and saying, 'This is a fight I can take on.'"

That's because unlike Corbett, Herbert is in a position where he doesn't have to make a deal with the Obama administration to stay in office, Burbank said. Herbert has announced he's running for re-election in 2016.

"I don't think he loses anything in terms of politics to say we just couldn't do anything, we couldn't strike a deal," Burbank said, even though that may be a bad policy decision.

Utah Department of Health Executive Director David Patton, who has been talking regularly with the administration about the plan, said there could be an answer about the work requirement next week.

"I think they will either tell us no or that they're going to think about it and find a way to do it," Patton, who will be in Washington with the governor, said. But, he said, a "no" from Health and Human Services shouldn't spell the end of the plan.

"To turn our backs on this issue would be a mistake," Patton said. "We're going to see the secretary next week. We may want to go beyond that, to Congress, maybe the vice president, maybe the president."

He said approval from both the federal government and the Legislature needs to be in place quickly in order to begin providing health care coverage in January. That would likely be through a bridge plan until Healthy Utah can be put in place.

Herbert's plan, which would help low-income Utahns buy private health insurance, will take about six months to implement, Patton said, while setting up temporary coverage will take three months.

"It's the timing I'm very concerned about. The longer we get approval delayed, the longer it takes to implement," the Utah health department head said. "A lot of people in Utah need the help."

The governor's plan would cover some 111,000 low-income Utahns, including nearly 60,000 who fall below the federal poverty level and do not qualify for health care subsidies under Obamacare unless the state accepts the Medicaid expansion.

Some two-thirds of the Utahns who would be covered by the plan already are working and others would be exempt from the work requirement because of disabilities.

Herbert said last week he sees no room for compromise on the work requirement but is still "cautiously optimistic" he can persuade the administration to accept his "common sense" work requirement.

"We're making headway, a little slower than I had hoped," the governor told reporters after the taping of his monthly news conference on KUED Ch. 7. "But until the deal is done, it ain't done."

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