Dan Liljenquist: Utah's Medicaid reform has been a quiet success

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  • 2 bits Cottonwood Heights, UT
    April 11, 2014 3:56 p.m.

    I know it sounds harsh, but expanding medicaid isn't the only way to skin this cat.

    No solution is going to get EVERYBODY signed up.

    Some people who have resources to get insurance still won't. No matter what you do. Unless... of course... it's free...

  • Gandalf Salt Lake City, UT
    April 11, 2014 12:42 p.m.

    And what I'm saying 2 bits is that there are literally tens of thousands of Utahns who didn't qualify for Medicaid before and who will qualify for Medicaid under Medicaid expansion.

    You appear to believe that all individuals under 100% of the federal poverty line qualify for Medicaid. That is not true. There are over 50,000 individuals who cannot get Medicaid, regardless of how impoverished they are, because the program currently doesn't cover certain people.

    Adults without dependent children, for example, don't qualify for Medicaid in Utah. Period. It doesn't matter how busted poor they are. They have no access to health coverage other than showing up at the emergency room. Your response to these 50,000+ people is to shrug your shoulders and say, "too bad, so sad, but I'm sure none of you will die because of it."

    But when you say "nobody's required to go without insurance . . . its a choice," you are simply wrong. And yes, the decision made by the state legislature and the Governor to not expand Medicaid expansion and provide coverage for these folks is actually killing people. For no good reason.

    Do these facts matter to you?

  • 2 bits Cottonwood Heights, UT
    April 11, 2014 9:54 a.m.

    What I'm saying is... if you qualified for medicaid before... you still qualify. So how is not expanding going to kill more people than before?

    I'm also saying that just because you don't qualify for Medicaid... doesn't mean you can't have insurance. You may have to pay a little... but you CAN get it.

    If you literally can't afford ANY of the exchange options... you probably qualify for Medicaid.

    If you don't qualify for medicaid... either your income is too high.. or you have too much money in the bank.... the government expects you to PURCHASE insurance.

    If you refuse to purchase insurance... what can we do?


    Bottom line... Nobody's being thrown off medicaid. If your income really indicates you can't afford to purchase anything... you qualify for medicaid. Nobody's being killed. And nobody is being required to go without insurance. It's a choice. It depends on your priorities. If you literally have no money for insurance... you qualify for medicaid.

    Nobody's required to go without insurance... it's a choice.

  • Gandalf Salt Lake City, UT
    April 11, 2014 9:21 a.m.

    2 bits, SB 180 did not expand Medicaid coverage in Utah at all. That was not its purpose. It simply made the program more financially stable and aligned economic incentives to attempt to provide better care to those who already qualified. And your comment about nobody dying because Utah has not opted into Medicaid expansion? A bit too flippant my friend. Everyone who has made a thorough, good faith effort to look at the effect of expanding Medicaid (or not) has concluded that expanding Medicaid will save lives. Do you honestly believe that no access to medical treatment will not have an adverse impact on individuals' health outcomes? Or that getting treatment at emergency departments only when a condition becomes so acute that emergency treatment is necessary is the most cost effective way to treat injury and illness? You are naive if you think that having emergency healthcare only for people who can't afford health coverage will not cost us lives.

    But you are not naive. You're a conservative. Today's modern conservative. Proud of it too I'm sure.

  • 2 bits Cottonwood Heights, UT
    April 11, 2014 9:06 a.m.

    If you still don't have coverage... did you shop the exchanges and TRY to get coverage? Or did you just demand medicaid expansion?

    If you shopped the exchange for affordable coverage and couldn't find anything... there's supposed to be help for people in your situation. You would qualify for a subsidy, or for Medicaid. They didn't cut Medicaid back... they just didn't expand it...

    If you can afford insurance... but decide it's not important enough to PAY for it... you can't really blame the State for your decision.

    If you don't qualify for medicaid... your income is too high (and it was too high before)... you're going to have to pay a little. But it's better than going without insurance and paying 100% of your healthcare expenses...

    If you're unemployed... you qualify for medicaid already. No expansion needed.

    If your working and can afford to pay a little... you're not going to be able to get on medicaid. But you CAN get a subsidized policy (IF you shop the exchange, call the help line, and find a policy for your situation).

    People who qualified for medicaid before... still qualify.

  • one old man Ogden, UT
    April 11, 2014 8:16 a.m.

    Yeah, right.

    What about all those Utah families who still do not have coverage?

  • cmsense Kaysville, UT
    April 10, 2014 6:12 p.m.

    Obamacare also experimented with ACO's. About half saved a little money and about half actually cost more money. The low hanging fruit has already been ringed out of healthcare by HMO's. American's expect the best cancer treatments, surgical care, obesity related illnesses, and end of life care etc and we seemingly let monopolies like pharmacuticals charge what the market will bare such as the 1000 doller per pill treatment for Hep C that just came out. (Anticipated cost for this one treatment around 10 Billion per year) Few other countries allow such pricing. Republicans screamed death panels when common sense things such as doctor reimbursment for end of life counseling was suggested with obamacare and killed it. Doctors are known to use hospice or less intervention at higher rates than the general public. More people would likely choose less intervention and maybe even have higher quality of life the last few months of life if provided such counseling which would save billions.

    In the meantime over 50,000 Utahn's who would qualify for medicaid are still waiting and suffering. I wouldn't call that a quiet success, I would call that quiet suffering.

  • 2 bits Cottonwood Heights, UT
    April 10, 2014 12:18 p.m.

    Hmmm... day's half over and no comments... I wonder why...


    I thought it was "life or death" that we expand Medicare in Utah... did we all die? I don't think so.

    Did anybody die? I don't think so.


    Did people who couldn't afford insurance before get it?

    Some did. Some didn't. I know a lot of young people who didn't even call and check prices. I don't know why. Obviously it wasn't "life or death" to them...


    I sincerely hope that everybody who needed insurance took the time to call in and get it. I hope there's an affordable option for everybody. But I realize that paying ANYTHING for insurance.. is too much for some people.

    I really hope nobody will literally die if we don't expand medicare in Utah and take this path instead.


    Maybe this will spur some comments....