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Governor Herbert

SALT LAKE CITY — Gov. Gary Herbert said Tuesday he'll sign a House bill he expects to pass this session that would extend Medicaid coverage to only the most vulnerable among the Utahns currently without federal health care assistance.

"This is definitely people coming together and finding a solution. It's making it better," the governor told reporters during his regular media availability. "I expect it to come to my desk, and I'll sign it."

But Herbert, who last year supported a more expansive proposal to provide health care to low-income Utahns using funds available to the state under President Barack Obama's health care law, suggested the House plan may just be a start.

"There's always room for improvement," the governor said. "We don’t just set it and forget it. We come back and review and see if there are ways to make things better."

Earlier Tuesday, Salt Lake leaders also voiced their support for HB437, House Majority Leader Jim Dunnigan's Health Improvement Initiative, the day after the bill was approved by a House committee.

The Taylorsville Republican's bill would provide traditional Medicaid to some 16,000 Utahns, including those who are homeless, on probation or parole, or have substance abuse or mental health issues.

"There are people in our community in critical need today, and I feel a moral obligation to support any plan that can get them help," Salt Lake County Mayor Ben McAdams said during a news conference at the Capitol.

McAdams and fellow Democrats Salt Lake City Mayor Jackie Biskupski and Salt Lake County Sheriff Jim Winder are all backing Dunnigan's bill, as is the Salt Lake Chamber and a number of community advocates.

Biskupski did not attend the news conference, but her deputy chief of staff, David Litvack, said there are many in the community who see full Medicaid expansion as the "optimum solution."

But Litvack, a former Democratic House leader, said "there's simply not the political support to move in that direction. And we cannot let that be in the way of making a critical and important step forward."

A full Medicaid expansion bill, SB77, sponsored by Senate Minority Leader Gene Davis, D-Salt Lake City, has been approved by a Senate committee and is awaiting a vote of the full Senate.

Full Medicaid expansion would provide federal health care subsidies to about 110,000 Utahns, including some 60,000 who earn below the federal poverty level but don't qualify for any assistance unless the state accepts Medicaid expansion.

Senate Democrats released information Tuesday claiming SB77 would give coverage to all Utahns who qualify for Medicaid expansion at a cost to the state of $417 per person, while Dunnigan's bill would cost $2,259 per person.

Dunnigan said taxpayers' tab for his bill is about $17.5 million, with hospitals picking up 45 percent of the state's $30 million share of the $100 million federal program, a 70-30 match.

Under full Medicaid expansion, the federal government offers a 90-10 match to states. But Dunnigan and others have raised concerns about the lack of flexibility the state would have to limit enrollment and take other measures to contain costs.

Dunnigan said many members of the House want to help "those that are most deserving, those in extreme poverty, have behavioral and substance abuse issues. … And that's what this bill does."

The majority leader said some are also "very concerned that we don't just have an open-ended checkbook and start a program that might run out of control." He said cost controls are "absolutely critical" for many in the House.

The governor said he believes the presidential election will have a significant impact on the Affordable Care Act and that Utah might finally succeed in getting the federal government to agree to a higher match for just the Utahns in the coverage gap.

"There is a hope we can have more flexibility," Herbert said. "With changes in the White House, there may be an opportunity to improve."

Rep. Robert Spendlove, R-Sandy, is sponsoring HB411, which would require the state to request that higher match for Utahns earning below the federal poverty level again in 2017, after a new president takes office.

Spendlove said his bill, which has yet to be assigned to a committee for a hearing, compliments Dunnigan's plan.

But Dunnigan said he is focused on his plan, which also needs federal waivers.

He said he did not include the same requirement in his bill because he was "concerned that might weigh my bill down with the federal government. They might see that as a negative, and I don't want to add any baggage."

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