Utah Gov. Gary Herbert (R) signed into law on March 25 House Bill 437, a Republican-sponsored alternative to a Democratic plan to expand Medicaid more broadly under the Affordable Care Act (ACA).
HB 437 is the only Medicaid expansion plan in three years to pass through the GOP-controlled House and Senate.
The legislation extends coverage to approximately 16,000 childless adults who are homeless, in parole or substance abuse programs, or undergoing treatment for mental health problems, Brigham Young University’s Daily Universe reports. Because Utah’s limited plan would not expand Medicaid up to 138 percent of the federal poverty line, the state would receive less federal money than other states that have expanded Medicaid.
Medicaid expansion will cost Utah $50 million, or $4 million more than projected revenues, in the state’s 2017 fiscal year, according to the bill’s fiscal note. In fiscal year 2018, the program will cost $104 million, or $12 million more than projected revenues.
Derek Monson, director of public policy at the Sutherland Institute, says the legislation extends Medicaid coverage only to truly needy individuals.
“The bill defines [those in] ‘greatest need’ as those falling below an income threshold who also meet other criteria,” said Monson. “The income threshold [for qualified recipients] will be set each year in state budget legislation and is designed to be adjusted from year to year to cover as many people as state funding appropriated to the program allows.”
Monson says regardless of whether HB 437 works for Utah, no state Medicaid program is one-size-fits-all.
“States’ low-income health coverage needs are unique enough that I would hesitate to say that any particular Medicaid program provides a model for the entire country,” Monson said.
Breaking the Mold
Josh Daniels, a policy analyst at the Libertas Institute, says Utah’s Medicaid expansion benefits Utahans by breaking the ACA mold.
“This is a much more riveting program because it doesn’t sign for ACA-style Medicaid expansion,” Daniels said. “We can just use state money and literally expand our state’s Medicaid under our own terms to the populations we think are needy, using the traditional [Medicaid] match rate and not signing up for the uncapped liabilities that come with full Obamacare Medicaid expansion.”
Because HB 437 does expand Medicaid, although on limited terms, the bill may offer Republicans a defense against criticism from Democrats in an election year, Daniels said.
Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.
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