Lawmakers consider Obamacare option to expand Medicaid

2014-02-19T00:27:00Z 2014-03-01T08:34:06Z Lawmakers consider Obamacare option to expand MedicaidBilly Hesterman - Daily Herald Daily Herald
February 19, 2014 12:27 am  • 

SALT LAKE CITY -- House Republicans were briefed on Tuesday about an option Utah may turn to as Gov. Gary Herbert and state lawmakers consider the expansion of Medicaid in the state under the Affordable Care Act.

Standing before the 58-member House Republican caucus Rep. Dean Sanpei, R-Provo, unveiled a new proposal that would cost Utah $30-35 million per year to provide health care to some of the Utahns not covered by their own personal insurance or through government-provided insurance.

Sanpei's plan calls for Utah to create a two-year pilot program that would provide health care benefits to individuals who are below the federal poverty level, are not eligible for traditional Medicaid and are medically frail or the parents of a child. Those who do not qualify under the poverty level requirement may still be able to receive some help from the state in finding health care but that could come in the form of premium tax credits.

Sanpei explained that once the two-year program runs out, the state will then reevaluate and modify its program to adjust to what the state has learned during the first two years of its implementation. Also in 2017, states will be able to file for more flexible waivers from the federal government in regards to guidelines the state has to follow under the Affordable Care Act.

Sanpei was unsure how many of the estimated 60,000 Utahns, who currently cannot receive any health care due to a 'doughnut hole' in the affordable care act, would be able to benefit from this proposal. He said it is possible that all may receive some kind of aid from the state, but there was a possibility that only some will be able to receive the state-funded benefits.

"We are not going to be able to say we can fund everyone," Sanpei said.

Under the plan, the state would uncap enrollment in the Utah Premium Partnership Program and offer limited premium subsidies to those who qualify and have employer-sponsored coverage. Those without employer-sponsored coverage would be offered a defined contribution that may be used for enrolling in a health plan or obtaining health care service through a flexible spending account that is tied to a primary care provider such as a medical home.

The plan falls in step with what House Speaker Becky Lockhart, R-Provo, advocated for in her opening day remarks as it relies solely on state tax dollars and not on money from federal government. It also means Utah may miss out on receiving millions of dollars from the federal government that its residents are paying in taxes to expand Medicaid within the state since Utah would be doing its own program instead of a federal-based program.

Lockhart told reporters after Sanpei's presentation that it was a priority to her to not engage in "Obamacare" and that this was an opportunity for the state to find a sustainable way to provide health care to those in need without depending on the federal government. Lockhart blamed the federal government for creating the problem of having certain individuals not covered under the Affordable Care Act and expressed frustration that Congress has not been able to fix the problem it created.

"It is not a political point it is a fiscally responsible point," Lockhart said about not wanting to accept federal money for Medicaid expansion. "We are trying to be fiscally responsible here in the state of Utah."

Sanpei's proposal is only one possibility the state may consider in regards to Medicaid expansion. Senate Republicans have yet to discuss the matter, and Gov. Gary Herbert is also still mulling over options.

Herbert said in January that doing nothing about Medicaid was no longer an option for the state but has yet to announce what his vision is for how Utah will provide health care to those currently not covered.

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-- Billy Hesterman covers the Utah State Legislature and local politics for the Daily Herald. You can connect with Billy by email at or by

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