SALT LAKE CITY — A House Democratic leader wants voters to be able to answer a nonbinding "opinion question" on the November ballot about whether the state should accept Medicaid expansion to provide health care to low-income Utahns.
"Because the Legislature has not passed any form of Medicaid expansion or may just pass a very frail version, I think the public should weigh in on this particular issue," said House Minority Caucus Manager Patrice Arent, D-Millcreek.
Arent's bill to establish a procedure for submitting nonbinding questions to voters, HB275, was introduced Wednesday, but a second piece of legislation detailing exactly what she wants them to answer is still being drafted.
Polls have shown that Utahns favor Medicaid expansion, but majority House Republicans have stopped two attempts by Gov. Gary Herbert to use the hundreds of millions of dollars available under President Barack Obama's health care law.
In the 2015 Legislature, it was the GOP governor's long-awaited Healthy Utah plan. And last fall, it was UtahAccess+, a plan put together by Herbert and Republican legislative leaders.
Arent said Healthy Utah is "one possibility" for the proposed ballot question. Democrats have pushed unsuccessfully for the state to simply accept the existing federal program.
Without some form of Medicaid expansion, Utahns earning below the federal poverty level do not qualify for government subsidies. Plans to help only some of the Utahns in the so-called coverage gap are expected to surface this session.
House Majority Leader Jim Dunnigan, R-Taylorsville, said he is concerned that if there's a ballot question, lawmakers will use that as a reason not to take action again this session.
"I expect there will be quite a number that say, 'You know what? We don’t need to do anything this session. We’ll wait to see what the people say about it,'" Dunnigan said. "We’ll end up getting nothing this session."
And, he said, some lawmakers are already balking at taking up the issue again, especially since a new president next year could mean significant changes to the Affordable Care Act, also known as Obamacare.
Last year, Dunnigan's more limited approach to covering those in the gap passed the House but the Senate, also controlled by Republicans, wanted the governor's Healthy Utah plan.
Now Dunnigan is drafting a bill he said will provide coverage to about one-third of the 43,000 uninsured Utahns in the coverage gap expected to seek insurance, those in "extreme poverty" who are likely homeless and need care and treatment.
House Speaker Greg Hughes, R-Draper, said he doesn't believe "a question on Medicaid expansion could capture the complexity and how big a challenge it's been and how big of a challenge it is. I don't think you can boil it down to a question."
Hughes said for a ballot question on Medicaid expansion to give lawmakers a clear directive, it would have to detail what budget cuts or tax increases voters would favor to pay the state's share.
"The math speaks for itself," the speaker said. "I'm not going to lie to people. I'm not going to promise things that I don't think we can deliver. And I'm going to be very honest about it, even if it comes with criticism."
Senate Budget Chairman Lyle Hillyard, R-Logan, said a referendum on Medicaid expansion would also have to ask voters how to pay for it.
"I'm sure they'll all say, 'Tax the doctors or tax somebody else. Don't tax me,'" he said. "If you're really going to put it on (the ballot) and ask people's opinion, you need to carry the whole gamut of what that decision means."
Hughes said he would not hold up Arent's bill, but there are a lot of bills competing to be considered this session. Hughes said while he has proposed ballot questions in the past, too many would undermine the legislative process.
"To have the option to do it, I think, is fine," the speaker said, but it should not become "an everyday practice, where you would see ballots on Election Day have a lot of these different questions."
Arent said she doesn't anticipate the proposed new process being used frequently. She said in the instance of Medicaid expansion, it may make lawmakers pay attention to what voters have already been saying in polls.
Seventy percent of Utahns said they want some form of Medicaid expansion approved this session, according to a UtahPolicy.com poll conducted last month by Dan Jones & Associates.
"This is one that has gone on for years and years and years, and now it's time for the public to express their views through this process," Arent said, noting a ballot question "will probably have more weight because people are voting."
Senate President Wayne Niederhauser, R-Sandy, said lawmakers already know the answer to the question based on public opinion polls.
"It's nice a idea, but I don't think it gets us any more information than we already have," he said of a ballot question.
The Senate has not advanced a Medicaid plan this session. Niederhauser said the Senate is letting the House work through the issue and is waiting to see what it sends over.
Contributing: Dennis Romboy
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