The U.S. Supreme Court's ruling on the Affordable Care Act put the decision of whether or not to expand Medicaid coverage up to each individual state. Medicaid eligibility can be a very complex issue but at its most basic level is based upon household income as a percentage of the Federal Poverty Level. For a family of four the federal poverty level is set at $23,050. You can see the current income limits based on the FPL in the graph below.
If Utah decides to expand Medicaid coverage under the ACA the Utah Department of Health estimates that about 53,000 more Utahns would become eligible. The Federal Government will also pay 100% of the cost for newly eligible people through 2016 and more than 90% of the cost through 2020 and beyond. That means any people who fall in the green section of the graphs.
But, even if Utah doesn't decide to expand Medicaid coverage they will still have to face the added costs associated with the requirement that all people have some form of health insurance or pay a penalty. That requirement goes into effect starting in 2014. When that happens, the Utah Department of Health estimates that about 58,000 people who are currently eligible but not enrolled in Medicaid, will enroll. And that part of the ACA is not optional.
Over 10 years those increased costs add up to be about one billion dollars. About 80% of the total increased cost of Medicaid if they expand. Expansion itself will only cost the state $239 million dollars over that same 10 year period. That means that even if they don't choose to expand, Utah legislators will still have to find a way to pay for an almost billion dollar increase in Medicaid costs.
