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Medicaid expansion remains a big issue for Utahns, as the state waits for federal approval. But other issues will continue to be discussed as health care costs continue to rise.

SALT LAKE CITY — Nearly 30 percent of the bills discussed this year by the Utah Legislature were health care related, and 63 percent of those bills passed.

The biggest issue, aside from tax reform, said Rep. Jim Dunnigan, R-Murray, was Medicaid expansion.

Yet, lawmakers essentially overturned the will of the people, who had voted for full Medicaid expansion, opting to increase taxes to pay for it.

"Medicaid expansion has a long and sordid history in Utah and this was frustrating," Rep. Brian King, D-Salt Lake City, said Wednesday during a panel discussion as part of the 2019 Utah State of Reform Health Policy Conference at the downtown Marriott. He said the Legislature's replacement effort is "a worthy endeavor," but he's not optimistic that all the waivers needed to implement it will be approved by the federal government.

Policymakers met to discuss not only access to health care, which could be increasing in Utah, but the rising costs and other issues that plague Utahns.

"Our state suffers diseases of despair," Dr. Joseph Miner, executive director of the Utah Department of Health said during his keynote address. He said Utah ranks high in opioid overdoses, as well as suicide. Recent improvements in those categories have to do with other states getting worse, not necessarily Utah getting better, though the state is seeing some progress with various implemented life-saving measures.

Miner told the more than 200 Utah leaders in health care in attendance that people's behavioral patterns — including drug and tobacco use, nutrition, physical activity, sleep, violence and injury — make up the majority of their overall health determinants. He said a solution could be more public money spent on social support systems, as is the case in countries that ultimately have better health outcomes.

"Many of the poor outcomes we're experiencing in the United States, compared to other nations doing it differently, is that they provide more social support to help people not be in despair and not be hopeless and really think about the other aspects of health care beyond clinical care and access to clinical care, which are also critical," Miner said.

"Our primary goal is to be the healthiest people we can be," he said, pointing to the mission of public health.

Lawmakers who participated in various panels on Wednesday discussed mostly Medicaid expansion — getting people access to the care that they might need — and how it changes things in Utah.

"I see it as a generational change as to how we think about health care in our state," said Rep. Ray Ward, R-Bountiful, a physician who has long been a proponent of expansion.

"We have a plan in place — it might … be insufficient, but we have a plan in place for everyone to get some basic coverage," he said. Should the waivers not be approved by the federal government, Ward championed a fallback to make expansion "fiscally sustainable to the state."

He said lawmakers will continue working on health care-related issues, including medical marijuana, health care cost transparency and affordability. Others said health care for inmates will continue to be a big issue in the coming years, as well as mental health and balanced billing.

"For the next year, implementing that big thing (Medicaid expansion) is the most important thing we'll be doing," Ward said, adding that a lot of people who have been turned down for Medicaid in the past might not know that they are again eligible.

The daylong conference, hosted by State of Reform, aims to keep the dialogue on health care reform going — to bridge the gap between health care and health policy. In addition to the Salt Lake conference, the nonpartisan group is hosting similar events in 13 markets this year.

"Health care, as we all know, is complicated," said Utah Rep. Ben McAdams, who also spoke at the conference. "It is also a big part of our economy."

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"U.S. health spending is growing faster than the broader economy, which means more money is being taken out of people’s paychecks to pay for a system that both worries and frustrates patients," McAdams said, adding that the majority of payments go to Medicare, Medicaid and private health insurance.

He said that while the Affordable Care Act is not perfect, it is helping. McAdams also outlined bills he is backing to further address health care issues facing the American people, but particularly Utahns.

"I am committed to working for bipartisan solutions that will move the debate forward and will result in meaningful action toward making affordable, quality health care available to everyone in our country," he said.