SALT LAKE CITY — The Salt Lake County Board of Health voted unanimously Thursday to support the Medicaid expansion ballot initiative that voters will decide on in November, but decided to wait until at least next month to take any official position on Utah's medical marijuana initiative.
The volunteer group has consistently favored full Medicaid expansion in recent years while the issue has been considered at the state Legislature, and Thursday's decision "was a continuation of that," explained Clare Coonan, chairwoman of the board.
"It was pretty natural of them to support that measure," concurred Salt Lake County Health Department Executive Director Gary Edwards, whose agency presented information about the measure before the vote.
The county health department described several factors to consider, including the number of people who could enroll in Medicaid due to expansion and how it would affect Utahns' tax dollars.
Edwards clarified the county health department does not request that the board take any particular position, but instead tries to provide a complete analysis to use in guiding the department's decisions.
The ballot initiative would enact a sales tax increase to expand Medicaid coverage to all Utahns up to 138 percent of the federal poverty level, making up to about 150,000 people newly eligible for federal health benefits.
Every state dollar used for expansion would be matched by nine federal dollars toward the program, as provided for under the Affordable Care Act. The initiative campaign Utah Decides Healthcare has estimated the overall price tag for expansion would be $800 million.
"If we got more people covered, more people access to health care, our community will be healthier," said Dr. William Cosgrove, a pediatrician and member of the health board. "The goal is to improve the health of our society."
Cosgrove, who also chairs the volunteer-run Utah Medical Care Advisory Committee, added that "the 9-to-1 (federal) matching rate makes it efficient to do this."
The state Legislature this year passed a bill seeking approval for Medicaid eligibility expansion up to 100 percent of the federal poverty line while also using 90 percent matching funds, reaching about 70,000 to 90,000 potential new enrollees. Lawmakers supporting that measure have said they don't expect it would raise taxes.
Utah Decides Healthcare insists the initiative would supersede what was passed by state lawmakers, though the Department of Health recently said it was still exploring the legalities of that scenario.
No decision on medical marijuana
Edwards presented information to the board about the ways in which marijuana would be made available to some Utahns if the medical cannabis initiative passes, after which the board opted to delay taking any position until at least next month.
Some board members said they wanted more time to review the details of the initiative and get a better grasp of the existing research into marijuana's medical properties. Coonan reminded the board not to "limit ourselves" to taking a position directly for or against the measure.
"There may be something else as a board we want to advocate for," she said, including more broad statements about medical marijuana research or legalization efforts in general.
The initiative would allow Utahns with certain listed conditions or illnesses to purchase marijuana legally under state law if they qualify for a medical cannabis card as determined by their doctor.
"The board is conflicted, because this is a messy area," said Cosgrove, who himself is against the measure.
Speaking for himself, Cosgrove said he believes "there isn't strong enough scientific information to make a statement either way" on the issue in the board's official capacity.
Next month, he said, he believes the board is "still going to be on the horns of a dilemma of good versus harm."
"This is a wide open, hard to answer question," Cosgrove said, but he is against the initiative largely because of what he believes is the greater risk to children that accompanies wider overall accessibility to marijuana. He also has reservations about what he says is uncertainty surrounding what dosing levels and delivery mechanisms are appropriate for patients who could benefit.
The medical marijuana initiative campaign, the Utah Patients Coalition, have argued it is a strict measure designed to do no more than open up options for patients with a genuine need for pain management.
Russell Booth, one of two vice chairmen of the Salt Lake County Board of Health, said he had some misgivings about the initiative, but also worried whether current Utah law is doing enough to address patients' needs.
"What would happen if it doesn't pass? How can the people that really need it for pain, etc., how can they be serviced?" Booth asked the board non-rhetorically. "We're on a continuum … and I'm having trouble finding the line."