Wednesday, January 23, 2019

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.

No comments:

Post a Comment