Ravell Call, Deseret News
Jennifer Meyer-Smart speaks during a public hearing for the state Medicaid program in Salt Lake City on Thursday, May 17, 2018.

This November, Utahns will consider Proposition 3, which would have enormously harmful fiscal and human consequences — particularly for the least fortunate — and deserves an emphatic “no” vote.

Prop 3 would fully expand Medicaid under Obamacare, adding nearly 200,000 able-bodied, childless adults to a program that was designed for low-income pregnant women, children, elderly and disabled. It would also raise Utah’s sales tax by nearly $90 million per year to pay for it. But Prop 3 would not allow a work requirement on recipients.

Passing Prop 3 would force vulnerable women and children to compete with able-bodied adults for the limited number of health providers who will see Medicaid patients (many providers don’t take Medicaid because of lower reimbursement rates compared to private insurance).

Furthermore, since the federal government will pick up at least 90 percent of the tab for the able-bodied newcomers to the program versus the 70 percent Utah gets for the traditional Medicaid population, which group do you think will get priority?

And while you might think the federal government picking up 90 percent of the tab makes this a no-brainer, think again. The numbers are so large that the 10 percent state share is more than big enough to blow a hole in Utah’s budget — as it’s done in other states.

For proof, we just have to look to other states now experiencing buyer’s remorse in the form of gaping budget shortfalls, millions in unfunded liabilities, a reduction in government services and higher taxes, all after expanding Medicaid.

Right next door, Coloradoans have seen Medicaid grow into one of the state’s biggest expenditures. For example, last fiscal year the department managing Medicaid had a budget of $9.4 billion and composed about a third of the state’s budget.

Colorado isn’t alone. One study found that between 2013 and 2016, total Medicaid spending (state and federal dollars) grew nearly twice as fast in states which expanded eligibility relative to those which did not.

This is precisely what’s happening in another neighboring state. Nevada is staring at a $56 million Medicaid deficit this fiscal year. Marta Jensen, head of the state department that administers the program, worries that they may have to go hat-in-hand to the Legislature for additional funding.

But there’s more than fiscal disaster at stake. It can also be matter of life-or-death.

Unless Nevada is able to come up with the additional funding it needs, it may have no choice but to reduce contributions to foster care providers servicing special-needs children. This is not unlike what happened in Arizona, which was forced to cancel life-saving organ transplants for Medicaid patients after expanding eligibility.

These unhappy outcomes were a predictable result of expanding eligibility to include able-bodied working-age adults. Another neighbor, New Mexico, had nearly 44 percent of the state’s population on the Medicaid rolls last year.

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Adding insult to injury is that the $90 million in new sales taxes will fall disproportionately on those least able to afford it when they buy things like groceries, clothes, and medicines. Indeed, the lowest 20 percent of Utah earners paid roughly 6 percent of their family budget on sales and excise taxes in 2015. Proposition 3 would make it worse.

Utah deserves better than asking our lowest-income earners to pay more in taxes for a new program that prioritizes the able-bodied over the disabled, the elderly and expectant mothers.

The choice is clear this November: Vote “no” on Proposition 3.