SALT LAKE CITY — A bill pitched by proponents as a more financially responsible way of expanding Medicaid coverage than the voter-approved Proposition 3 is already headed to a vote by the full Senate.
Members of the Senate Health and Human Services Committee voted 6-2 Tuesday to advance SB96, sponsored by Sen. Allen Christensen, R-North Ogden, after a 1 1/2-hour hearing before a standing-room only audience.
"The bottom line is we are expanding Medicaid," Christensen said just before the vote advancing the bill to the Senate floor. "We are doing as Prop. 3 voters wanted in a fiscally, financially responsible way and getting it done."
He said he remained "philosophically opposed" to Medicaid expansion, available under the Affordable Care Act to provide health care to those earning less than 138 percent of the federal poverty rate that's about $12,000.
But Christensen said because voters passed full Medicaid expansion last November, he put together a bill that covers a portion of that population along with a new work requirement and other changes that will all require federal approval.
A so-called bridge plan would be put in place starting April 1 at a lower 70-30 federal funding match than full expansion — again, requiring a federal waiver — while the state seeks permission for a permanent program with a 90-10 match.
SB96 has the backing of Senate GOP leadership. During a closed-door Republican Senate caucus before the hearing, a majority of senators said they supported the bill, according to Senate Majority Whip Evan Vickers, R-Cedar City.
The two Democrats on the committee, Senate Minority Whip Luz Escamilla of Salt Lake City and Senate Minority Assistant Whip Jani Iwamoto of Holladay, voted against the bill after questioning funding assumptions made about full expansion.
Another Senate bill that would simply repeal the full Medicaid expansion set to take effect on April 1 without legislative action was not considered by the committee. Sen. Jake Anderegg, R-Lehi, the sponsor of SB97, said that was not his decision.
Vickers said that Anderegg's bill was not discussed in the caucus meeting. "I'm pretty confident in saying at this point there is no appetite at all to repeal the proposition," the majority leader said.
Christensen's bill expands Medicaid only to those earning less than 100 percent of the poverty rate, relying on the existing subsidized insurance already available to take care of some 41,000 Utahns earning between 100 and 138 percent of poverty.
It also requires recipients to seek employment, imposes potential enrollment caps, and adds $30 million, including a $15 million hospital tax, to the 0.15 percent sales tax increase approved by voters in Proposition 3.
But in order for the state to receive the 90-10 federal funding match available for full Medicaid expansion, the Trump administration will have to agree to a waiver. A similar request was not granted last year for a more limited expansion program.
Christensen said he has been "virtually assured" the needed waivers will come through. Under the worst possible scenario, he said enrollment in the bridge program would have to be capped.
Rep. Jim Dunnigan, R-Taylorsville, who helped present the bill to the committee, acknowledged a waiver will be needed even for the temporary bridge plan. He said it should be in place by April 1.
Many in the audience signed up to testify at the committee hearing, but only a few were allowed to speak.
"Voters knew what they were doing," Stacy Stanford, an analyst with the Utah Health Policy Project, told the committee after describing how she lost her job and health care insurance nine years ago after being seriously injured in a car accident.
Then, Stanford said, she fell into the so-called coverage gap, earning too much to receive Medicaid but too little to qualify for subsidized insurance, and racked up some $250,000 in debt.
She said voters approved full Medicaid expansion by nearly 70,000 votes statewide.
But Heather Williamson of the Utah Chapter of Americans for Prosperity called Medicaid expansion a "catastrophe" for states around the country, preventing some people from getting the care they need because costs rose beyond forecasts.
David Hesington, who has served as a bishop in The Church of Jesus Christ of Latter-day Saints, said there's a burden when the state doesn't deliver on needed services for people in need.19 comments on this story
He said while the poor "sleep on city streets," lawmakers are saying they can't afford full Medicaid expansion and, at the same time, talking about at least a $200 million tax cut and paying for a new state office building at the Capitol complex.
Before voting against advancing Christensen's bill, Escamilla said she hoped the Legislature would respect the voice of the voters.
"I don't know what the hurry is," she said.
There was only one outburst during the hearing, when someone testifying said he was there representing the 53 percent of voters who approved full Medicaid expansion and members of the audience burst into applause.
They were quickly admonished by the committee chairman, Sen. Ronald Winterton, R-Roosevelt.