The callous gutting of Medicaid Expansion

On November 6, Utah voters took to the polls and told lawmakers that expanding healthcare coverage to thousands of vulnerable Utahns is a priority for our state. Medicaid Expansion passed, but some Utah legislators aren't happy with the outcome, so efforts are underway to kill it. There is a bill reportedly sponsored by Senator Allen Christensen and Representative Jim Dunnigan that will create changes to the law that will render it impossible to implement and will not allow our state to offer the coverage that we voted on.

Here are the details as I understand them: The proposed law will 1) Impose a work requirement; 2) Create a spending and/or enrollment cap; 3) Limit enrollment to individuals at 100 percent of the federal poverty or lower. All three of these positions are not in alignment with the current law passed by the Affordable Care Act and require the state of Utah to apply for a waiver in order to secure the federal match for an expansion population. But there is a huge problem with the waiver that Sen. Christensen and Rep. Dunnigan are proposing.... Utah already submitted an identical waiver and it was not approved.

But here is what is most frustrating: the bill sponsors claim that the tax increase that voters approved in order to fund expansion will not cover the costs five years down the road. The assumptions used for that conclusion are questionable. More importantly, the "bogeyman" of a funding strain is nonsense. The estimated budgeting shortfall, if it even happens, is, at most, $60 million. Now... that's not nothing. I recognize that $60 million is a lot of money. But maintaining some perspective is critical. $60 million is one percent of our states $6 billion Social Services Appropriations budget, and only 0.33 percent - one third of one percent - of our state's total budget. In my estimation, providing coverage for 150,000 vulnerable Utahns is more than worth a third of a percent of our state budget. In fact, I know that voters agree that it is worth it. We voted for it.

There is no sound reason to gut a citizen-passed law under the guise of budgetary strain, particularly when the exact same people are planning to offer high-income tax payers a $200 million cut over the next budgeting cycle. As they say, you can't make this stuff up. State legislators, I believe, are emboldened by the seeming lack of political fallout after decimating the Medical Cannabis law, also passed via citizens' initiative. But voters across the state must insist that their representatives preserve the law passed via Prop 3. We won't have another opportunity to ensure that all Utahns have the ability to gain the healthcare they need in order to be healthy and productive, and to pursue lives that are meaningful and fulfilling.

Climbing the learning curve

Here we are, only a few short weeks from the start of the 2019 General Session. My mind spins at the scope of the information that I have obtained and, more significantly, have yet to absorb. And so, I am so very grateful for all of the advocates and lobbyists (yes, lobbyists) out there who are willing to provide information and perspective on their respective issues and areas of expertise. Before we move on, let's revisit that "lobbyist" term. Yes, there are bad actors. There are unscrupulous, personal-gain-driven, untrustworthy lobbyists in our state. There are also truly good people trying to do truly good work in Utah. State law requires anyone whose paid job is to advocate for policy issues at the Utah Capitol to obtain and maintain licensure as a lobbyist. It is what I used to do for a living. As a registered lobbyist (my license, not my job title), my job was to provide education and insight on healthcare and public health policies on which I had gained a certain level of expertise. All legislators depend on knowing trustworthy, knowledgable people to help inform on critical issues. While (the current) we (as legislators) try our best know as much as possible about as much as possible, it simply isn't possible to know it all. So (the former) we (lobbyists and advocates) work hard to provide timely information on policy issues that have the potential to impact millions of lives in our state.

Rest assured, I do not always take the information that is presented to me at face value, but I do value knowing who the advocates and lobbyists are, what issues they work on, what resources they may be able to provide so that I have ready access to all kinds of information, and what their strategies may be. Even if I don't agree with someone on an issue, having all of the information on both sides of an argument is essential to making wise, informed decisions. The decisions made at our state capitol have significant gravity, and we would be doing the people of our great state a huge disservice if we failed to maximize our own understanding and education. For that I need access to knowledge and experience, and I need it quickly and efficiently.

I'm grateful for all of the people with whom I've met over the past couple of months and to those that I will have the opportunity to interact with in the future. If you've got some info you think I need, be sure to let me know. I will be better at my job if you help me build the breadth and depth of my own knowledge, and for that, in advance, I thank you.

Be sure to check back in a day or two for a post on what I've got coming up this session. I'll do a run down of the bill files that I've opened and, more importantly, some thoughts on the legislative priorities of my colleagues, both nefarious and beneficial.

Finally, here are is a link with contact info. Don't forget, if you're a constituent and you wish to email, please put the word "Constituent" in the subject line (those are the emails that I will prioritize). Phone calls are, of course, welcome, but I'm likely to respond more quickly if you send me a text message: 385-321-7827.

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