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Ravell Call, Deseret News
Alan Ormsby, left, of AARP Utah, Karina Andelin Brown and the Right Rev. Scott B. Hayashi, bishop of the Episcopal Diocese of Utah, deliver the Utah Decides Healthcare ballot proposal to Thais Stewart, a receptionist in the Utah Lieutenant Governor's Office, at the Capitol in Salt Lake City on Monday, Oct. 2, 2017. If approved by voters on Election Day in November 2018, the proposal will ensure medical care for all individuals and families in Utah with incomes less than 138 percent of the federal poverty line.

SALT LAKE CITY — Supporters of full Medicaid expansion in Utah officially filed an application Monday at the state Capitol to take the issue to voters in 2018.

The campaign, Utah Decides Healthcare, is pushing for Medicaid eligibility for tens of thousands of Utahns who do not qualify for all-important tax credits on health insurance plans offered on the federal exchange.

"The initiative will provide vitally needed health care to our most vulnerable citizens, hardworking families and low-income individuals who need it the most," Dina Blaes, initiative campaign spokeswoman, said in a statement.

The application was submitted to the lieutenant governor's office, which has 30 days to review the language of the initiative to make sure it meets minimum thresholds such as not being blatantly unconstitutional or nonsensical. If given the green light, organizers will need to collect 113,000 signatures by April 15, 2018, meeting certain thresholds of signees in 26 of Utah's 29 Senate districts, in order to get the initiative on the ballot.

The initiative would expand Medicaid coverage eligibility to all Utahns whose income is 138 percent or less than the federal poverty level, making insurance available to Utahns who make too much to qualify for Medicaid but not enough to be eligible for vital tax credits toward any coverage plans on the federal health exchange.

Organizers said the initiative calls for a sales tax increase from 4.7 percent to 4.85 percent to raise $91 million to pay for the expansion. Those funds would then draw down matching funds of a little more than $800 million from the federal government, according to the campaign.

Signatories on the application include Sen. Brian Shiozawa, R-Cottonwood Hieghts, and the Right Rev. Scott B. Hayashi, bishop of the Episcopal Diocese of Utah. The others are Beth Armstrong, executive director of the nonprofit People's Health Clinic in Park City; Alan Ormsby, directory of AARP in Utah; and Karina Brown, a Logan mother whose own mom was uninsured when she recently died at 64 years old.

Bishop Hayashi said he is optimistic the initiative will both make it to the ballot and pass.

"(Utahns) care deeply about each other," he said. "I'm very, very hopeful. … I know people are very compassionate."

Bishop Hayashi and other supporters of the initiative say they're encouraged by polling showing most Utahns favor Medicaid expansion.

"We're speaking directly to the people of Utah … after four years talking about it at the Capitol," he said.

Shiozawa, an emergency room doctor who serves on the Utah Legislature's Health Reform Task Force, was traveling Monday but offered an economic argument in favor of the initiative in a prepared statement.

"We can either be proactive and get some of our federal tax dollars coming back to Utah in the form of federal match grants, or we can sit here doing nothing and watch our homelessness problem and overall health care worsen, while continuing to pay these taxes," Shiozawa said. "That makes no sense at all. I think we ought to let the people of Utah have a say in this."

State lawmakers settled on a significantly limited Medicaid package in 2016, following years of intense debate over whether to implement full expansion under the Affordable Care Act.

Most Utahns with dependant children and who make between 55 percent and 100 percent of the federal poverty level fall into a coverage gap — earning too much to qualify for Medicaid and too little to qualify for tax credits toward an insurance plan on the federal exchange.

Those tax credits cover 72 percent of the cost of premiums for Utahns on the exchange on average, meaning paying for a plan without them dramatically balloons a person's monthly costs, according to the Utah Health Policy Project, one of the advocacy organizations supporting the initiative campaign.

The coverage gap is even larger for most Utahn adults without dependants. Only a few thousand people in that demographic — largely the most needy, such as those who are homeless — are the target of limited Medicaid eligibility expansion that state officials hope will be federally approved this fall.

In total, about 80,000 Utahns do not qualify for either Medicaid or for getting tax credits toward a plan on the Affordable Care Act, said Jason Stevenson, spokesman for the Utah Health Policy Project.

The initiative would also explicitly outlaw the creating of caps on enrollment in both Medicaid and the Children's Health Insurance Program in Utah.

Utah House Speaker Greg Hughes, R-Draper, who has been at the forefront of the debate over Medicaid expansion in recent years, said last week that the initiative seems to him to be fiscally unsound. That was largely due to Medicaid being an open-ended government program, with no fixed spending limit, he said at the time.