Some of Utah’s healthcare powerbrokers are honing in on a plan to expand Medicaid that they think the state legislature might approve. At a healthcare conference in downtown Salt Lake City Thursday, former lieutenant governor Greg Bell - now president and CEO of the Utah Hospital Association – laid out his vision.
Bell says the state’s decision on Medicaid expansion will really be decided by the Utah legislature.
“The Governor has the legal right to decide to expand Medicaid, however it has fiscal implications. So as a practical matter, the legislature has to finance this. He’s not going to go out as a sole actor without support in the legislature,” Bell says.
If Utah decides to offer Medicaid coverage to all adults up to 138 percent of the poverty level, the federal government will pick up the full cost of that expansion through 2016, and then pay 90 percent of the costs after that. But conservative Utah leaders have said they're wary of federal spending and worried Washington may not be able to keep that promise down the road. Bell says realistically, the legislature will not approve of a full Medicaid expansion, but The Utah Hospital Association is endorsing a unique hybrid solution which will still ensure that all Utahns have access to health coverage. Bell says Medicaid should cover those most in need - up to 100 percent of the poverty level.
“These are folks who a single person makes $11,500 or less. These are the poorest of the poor. It’s part of the social safety net that we have that we care for the poor, and there is no alternative for them,” Bell says.
The Hospital Association suggests that those with slightly higher incomes could use Medicaid dollars to purchase insurance in the private market. If the Governor and Utah legislature were to approve this alternative approach, the state would have to apply for a federal waiver.