SALT LAKE CITY — A bill backed by Republican House leaders extending Medicaid coverage to Utahns in the "greatest need" because of homelessness, run-ins with the law, substance abuse or mental health issues won committee approval Monday.
"We have the opportunity to improve the lives of 16,000 of our fellow Utahns," House Majority Leader Jim Dunnigan, R-Taylorsville, the sponsor of HB437, told members of the House Business and Labor Committee. "They need our help."
Dunnigan said his proposal to offer assistance to the poorest Utahns currently without coverage under President Barack Obama's health care law is "a measured plan. It has cost controls in it, and I think it's the appropriate step at this time."
The plan is the latest attempt by lawmakers to deal with the more than 60,000 Utahns in the coverage gap, earning below the federal poverty level but without federal health care subsidies because Utah has not accepted Medicaid expansion.
Gov. Gary Herbert saw his Healthy Utah plan to use the hundreds of millions of dollars available under Obamacare to cover all of the estimated 110,000 Utahns eligible for Medicaid expansion pass the Senate but fail in the House last session.
Another plan to qualify for the 90 percent federal match offered for Medicaid expansion, drafted by the GOP governor and Republican legislative leaders in private during the legislative interim, mustered little support among lawmakers.
Dunnigan's plan would extend traditional Medicaid to about 12,500 childless adults who are homeless, on probation or parole, or have substance abuse or mental health issues, as well 3,800 adults with dependent children.
The cost to the state is about $30 million, he said, with the federal government paying about $70 million. He said Utah hospitals will pick up 45 percent of the state's share, some $13.5 million.
The bill was advanced by the committee to the House by a vote of 9-4 after more than an hour of testimony and discussion.
Homeless advocate Pamela Atkinson told the committee that the bill will help those who stand to benefit the most.
"Would we like to cover more? Of course we would. But we know the money is limited, and we think this is a great way to start this off, by actually helping those people who are the most vulnerable," Atkinson said.
Keith McMullin, president and chief executive officer of Deseret Management Corp., the parent company of the Deseret News and KSL, spoke in favor of the bill on behalf of the Salt Lake Chamber of Commerce.
McMullin, who has served as managing director of The Church of Jesus Christ of Latter-day Saints’ welfare services activities, cited his decades of experience with "this most vulnerable population" in Utah and abroad.
"I understand society grows and prospers as it attends to those who are most vulnerable within it. I believe this particular initiative addresses that need within our state," he said.
Representatives of both Salt Lake City Mayor Jackie Biskupski and Salt Lake County Mayor Ben McAdams also endorsed the bill, as did Bill Tibbitts, associate director of the Crossroads Urban Center.
"These are populations, where if we don't provide them with services, society ends up paying a cost, paying in other ways," Tibbitts said, calling Dunnigan committed to "passing a bill that will work, that will help people and change lives."
Speaking against the bill was Chase Thomas of the left-leaning Alliance for a Better Utah. Thomas said it was "morally wrong" and "financially irresponsible" not to accept full Medicaid expansion.
A bill that would bring the federal program to Utah, sponsored by Senate Minority Leader Gene Davis, D-Salt Lake City, has passed a Senate committee and is awaiting a vote in the Senate.
Sen. Brian Shiozawa, R-Cottonwood Heights, who sponsored the governor's Healthy Utah plan in 2015, told the Deseret News he "had to make a pragmatic decision" to back Dunnigan's bill because "it's what can pass" the House this session.
"It breaks my heart as far as the coverage gaps goes," Shiozawa said. "The coverage gap we need to cover is far bigger. There are thousands of Utahns who will be hurt by not doing that and actually, scores will die."
But the senator, an emergency room doctor, said that if he had to choose between taking no action on Medicaid expansion again this session "or doing something, then I’ll pick something."
Shiozawa, who supports requiring the state to pursue a more favorable Medicaid expansion plan after a new president takes office in 2017, said he may be the Senate sponsor of Dunnigan's bill.
House Speaker Greg Hughes, R-Draper, told the Deseret News he was pleased lawmakers are "getting to place in this important issue where people are coming together and we're not letting perfect be the enemy of good."
Hughes, who has said there is no room for compromise on the bill, said there's still work to be done to get it passed. The speaker said Dunnigan's plan allows lawmakers to adjust coverage to the funds available.
But Hughes said he is not committed to eventually adding everyone in the coverage gap to what he called "a stand-alone program that has merit. To the extent that we would grow it or not, those are future decisions we have made possible."
The speaker said he had no message for the Utahns who still won't receive health care under Dunnigan's plan. Throughout the session, Hughes has said it would be difficult to pass a plan met with "contempt" or protests.
Last week, the governor said Dunnigan's plan was "certainly better than zero" but not what he would have liked to see from lawmakers. Still, he said it was important to find a plan that could win support from the Legislature this session.
Herbert spokesman Jon Cox said after the vote that the "governor appreciates the work of Rep. Dunnigan and others who haven't given up on finding a solution that covers the poorest of the poor."