Scott G Winterton, Deseret News
Members of the Utah Senate debate Medicaid expansion at the Capitol in Salt Lake City on Monday, Feb. 4, 2019.

SALT LAKE CITY — To those who think the Utah Senate’s decision to approve a bill changing Proposition 3 on Monday was a slap in the face to voters, the bill’s sponsor has a message.

He wouldn’t have voted for any sort of expansion if Proposition 3 had failed. So in that sense, he said, he heard the people.

“I’ve been against Medicaid expansion ever since it was brought up 10 years ago,” Sen. Allen Christensen, R-Ogden, told reporters. “The reason it’s being heard this year, especially with my bill, is because the people wanted it.

“They wanted a tax increase. They wanted Medicaid expansion. And that’s what we’re doing. They didn’t fill in the proper blanks. We are filling in those blanks for them. They are not obligated to balance the budget. We are, and we’re going to implement Medicaid expansion in a fiscally reasonable way where Proposition 3 did not provide for adequate funding of what it asked for.”

As he spoke, a truck with a giant video board circled the Capitol, playing a commercial that spoke ominously of backroom deals and overturning the will of voters. It was part of a $100,000 campaign by the backers of Proposition 3 to keep Christensen and other lawmakers from doing what they seem intent on doing.

Christensen’s bill passed the Senate on Monday, 22-7. Now it goes to the House, where other versions await. If the Senate’s version becomes law, all of Medicaid expansion could disappear unless the Trump administration comes through with waivers to the Affordable Care Act. Even with the waivers, some people the proposition would have covered would have to pay a small amount out of pocket for health coverage.

Whether or not average Utahns are aware of it, the Capitol is in the grips of a tug of war over what a voter-approved ballot measure really means. Lawmakers clearly hold the upper hand in the immediate debate, but the question is, what happens next?

Do lawmakers make it even harder to get an initiative approved for the ballot? Do interest groups wait the requisite two years and then push these initiatives again to override changes lawmakers have enacted? Or do voters instead push an initiative that would require lawmakers to keep their hands off a successful initiative until it has been on the books a few years?

In North Dakota, lawmakers can’t touch a voter-approved law for seven years without a two-thirds majority. Four other states require at least a two-year wait, with various rules for either amending or repealing them. Several other states require super majorities in the Legislature to make any changes, according to ballotpedia.org.

But on the other end of the spectrum, a report on citylab.com says 24 states don’t allow any sort of citizen initiatives at all, and none has added such a thing in more than 40 years. Empowering citizens comes with political risk.

Utah isn’t the only place where politicians are changing what voters approved. Citylab also reports that, while initiatives seem to be on the rise, overturning them is, as well. The website says this isn’t a bug in democracy, “it’s part of democracy’s design.”

The cycle goes like this: Lawmakers refuse to pass a measure voters want, voters organize (or are organized by special interest groups) and pass a ballot initiative, lawmakers amend or repeal what voters have done, and voters get the final say the next time their representative stands for re-election.

It’s just that the last step is a little disconnected from the rest, especially in a state where Republicans often get elected without much opposition.

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But lawmakers argue they have something else, as well — a duty to look out for the welfare of the entire state and its budget. They fill in the blanks because somebody has to. That explains how Christensen could push a watered-down version of Medicaid expansion and say he had heard the voters.

Which probably isn’t much comfort for the uninsured poor.

Back in 1900, when a different set of Utah voters first added initiative and referendum rights to the constitution, a socialist named Henry W. Lawrence predicted the fight had just begun.

That was insightful. I’m guessing it may never end.