Details of Medicaid expansion plan due next week

Details of Medicaid expansion plan due next week

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SALT LAKE CITY — Details of the much-anticipated new plan for Medicaid expansion from Gov. Gary Herbert and legislative leaders will be rolled out Tuesday to lawmakers in closed-door meetings before being unveiled publicly.

But the governor has yet to sign off on a final proposal, his spokesman, Jon Cox, said Wednesday.

"There are still details that need to be negotiated by the group," Cox said. "That's probably as specific as I would be. … I don't want to portray it's something that it's not. There is agreement on the framework but not agreement on the final bill."

That bill could be ready in time for Herbert to call lawmakers into special session in mid-October, during their regularly scheduled interim meetings. The plan is expected to be discussed by the Legislature's Health Reform Tax Force on Oct. 6.

Little information has emerged during the months of private discussions between the GOP governor and Republican lawmakers about how to use the hundreds of millions of dollars available to the state under President Barack Obama's health care law.

In July, the group announced a "conceptual framework" to cover all Utahns eligible for Medicaid expansion, and taxing hospitals and others in the medical community to pay for the state's share of the federal program's cost.

The governor has said the tax amounts to 7 cents for every dollar providers receive in federal funds. Utah eventually will have to pay 10 percent of the cost of extending subsidized care to some 100,000 Utahns, including those who now receive no help.


There is agreement on the framework but not agreement on the final bill.

–John Cox, governor's spokesman


Both House and Senate Republicans, who hold a supermajority in the Legislature, are set to meet in closed caucuses at the Capitol starting at 3 p.m. Tuesday.

Senate Democrats plan hold a caucus meeting Tuesday that they hope will include a presentation on the plan, but House Minority Leader Brian King, D-Salt Lake City, said House Democrats have nothing to talk about.

"Nobody's offered to come in and say a word to us," King said. "We haven't heard squat."

King and Senate Minority Leader Gene Davis, D-Salt Lake City, said the majority party may be taking Democrats for granted when it comes to the votes needed to pass a plan.

During the 2015 Legislature, the Senate approved the governor's Healthy Utah plan for Medicaid expansion. But that plan was rejected by the House in favor of a much more limited alternative known as Utah Cares.

Just before the end of the session, Herbert brought together the Republican sponsors of both plans, as well as House Speaker Greg Hughes, R-Draper, and Senate President Wayne Niederhauser, R-Sandy, to come up with a new proposal.

Niederhauser said that if he had been asked during last session's impasse what the chances were of getting a Medicaid expansion plan through the Legislature, "I would have said zero."

Now, the Senate leader said, the group is ready to provide lawmakers with a "complete vision of the plan" that includes ranges of what every provider group would have to contribute.

"By no means is it going to pass unanimously. There's going to be people who do not like the concept from the start," Niederhauser said. "None of us are really happy about this, but we're just trying to do what's best for Utah."

Hughes was not available for comment Wednesday.

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House Majority Leader Jim Dunnigan, R-Taylorsville, a member of the group that drafted what he called a "very nuanced and very complicated" plan, declined to discuss what reaction he expects from the caucus.

"We'll take the temperature and see what support there is," Dunnigan said, noting that even if lawmakers end up approving the plan, it will still require multiple waivers from the federal government.

Senate Majority Leader Ralph Okerlund, R-Monroe, said if there's not enough support in the House and Senate for the plan, Medicaid expansion would continue to be discussed in the 2016 Legislature that begins in late January.

"We'll go to Plan B, which is to go back to the drawing board and keep talking," Okerlund said. "I don't think we just reject it. I think we continue talking and working on it. It's been a long, difficult, drawn-out process."

Adding to that difficulty is pressure on elected officials from advocacy groups on both sides of the issue. Americans For Prosperity, a group associated with the nationally influential Koch brothers, has been especially active.

The Utah chapter of the group has been reaching out to voters in key legislative districts and holding town hall meetings opposing Medicaid expansion as "more Obamacare" that means tax increases.

A Republican lawmaker who supports Medicaid expansion, Rep. Ray Ward of Bountiful, said "the volume knob has turned back up in the last couple of weeks" on the issue.

"Everybody's talked and talked. I don't think much else can happen until there is a plan to discuss," said Ward, a doctor who treats patients in the so-called coverage gap. "I've supported this for a long time and would like a detailed plan to look at."

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Lisa Riley Roche

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