Under the theory that perhaps thousands of Utah college students are having babies paid for by Medicaid that they could pay for themselves, one lawmaker has a plan: cut all elective epidurals and elective C-sections.
Sen. Dan Liljenquist, R-Bountiful, has vowed massive Medicaid reform in next year's legislative session, and first on the list is people who may be freeloading. Medicaid pays for 15,000 births a year in Utah, a third of the total, Liljenquist says.
"Do we save some kid or make birth easier?" he said, noting that the waiting list for Medicaid in Utah just for the disabled has reached 4,400 people.
Liljenquist says the state could save millions. Epidurals, a shot given in the spine, are a common method of relieving pain during labor. At Utah Valley Regional Medical Center in Provo, 86 to 87 percent of women who deliver babies at the hospital get an epidural; studies show about 65 percent of births nationwide happen with an epidural.
Cesarean births have risen to nearly a third of all births nationwide and cost nearly double a vaginal birth. The average charge for a Cesarean delivery in Utah County in 2008 was $8,989, according to the Utah Department of Health. In 2008, the average cost of a vaginal birth in the county was $5,079, but that does not include an epidural.
On Wednesday, a group of senators including Liljenquist had an animated discussion about the matter after meeting informally on the Senate floor.
"These are 90 percent out-of-state students having babies on our dime," Sen. Howard Stephenson, R-Draper, told Liljenquist, referring to BYU students. Conservative lawmakers have been upset about anecdotal evidence of students with a Lexus and trust fund having a baby under Medicaid. They qualify because there may technically be no income.
During the legislative session earlier this year, Rep. John Dougall, R-Highland, caused a stir for saying the same thing.
House Minority Leader David Litvack said that before anything that drastic was done, he'd want hard numbers.
"I'm not making policy based on anecdotes," Litvack, D-Salt Lake City, said during a discussion with Liljenquist.
Liljenquist is targeting Medicaid next year because it has grown by $200 million in the past three years while the state has cut $1.2 billion from its general budget. Health services provided by the government should be a safety net, he said, not a provider of first resort.
"I don't want Medicaid to be the best program in the state, which it is," he said.