SALT LAKE CITY (AP) — A fast-moving proposal to scale back a voter-approved Medicaid expansion in Utah passed the state Senate on Monday over protests from activists who say it guts a plan the majority of voters want.
The proposal by GOP lawmakers would cover about 50,000 fewer people under Medicaid and add work requirements and spending caps. Leaders say those steps are essential to keep costs under control. The plan now goes to the Utah House.
“We are trying hard to figure out how to get the coverage that the voters said that they wanted” while meeting constitutional obligations to balance the budget, Republican Sen. Jake Anderegg said.
But with a potential shortfall at least two years away, advocates of Medicaid expansion argue the state should roll out the changes that won with 53 percent of the vote and call for dealing with any funding shortage as it comes. The rollout is set for April 1.
“It wasn’t a suggestion to the Legislature, it was legislation passed through citizenship,” said Andrew Roberts, a spokesman for Utah Decides Healthcare.
Around the country, a number of largely conservative state leaders have changed or brushed aside voter-approved laws in recent years, including Medicaid expansion in Maine that was initially blocked by the former Republican governor.
The changes now being considered in Utah go beyond those being considered in Idaho and Nebraska, the two other Republican-leaning states where voters passed similar measures in November, according to The Fairness Project, a national group that helped fund all three efforts.
The uncertainty is scary for Alecia Bales. The Utah woman has five children, and the family lives on her husband’s salary of about $40,000 a year, putting them just above the poverty line.
While her children have Medicaid coverage, she and her husband pay $600 a month for insurance through his work. The family is about to move into a home they helped build themselves, but she said their insurance is so expensive they’ll have to drop their coverage to make the payments.
“It scares me because there are so many things that can go wrong,” said Bales, 41, who has thyroid problems, chronic migraines and other health issues.
The couple would be eligible for Medicaid coverage under the voter-approved law, but in lawmakers’ version people whose incomes are above the poverty line would buy insurance on the federal exchange.
Bales said she’s that coverage would still be out of reach.
“I feel really frustrated,” she said. “Why vote at all if they’re just going to repeal what you voted for?”
Utah lawmakers can change voter-approved measures with a simple majority.
The changes are particularly frustrating in a year when state lawmakers have a billion-dollar surplus and are weighing the largest tax cut in state history, said Dawn Le with Utah Decides.
State leaders argue that some of that surplus is one-time money that couldn’t be used to plug potential Medicaid shortfalls in the future. A state budget analysis found a sales tax increase approved by voters could fall $10.4 million short of funding the program by the year 2021.
The voter-approved law would fully expand Medicaid under President Barack Obama’s signature health care law to people making up to 138 percent of the poverty line, or about 150,000 low-income people.
Lawmakers’ version scales that back to 100 percent of the line, so the state would need a special waiver to get the extra federal money promised to help fund the expansion.
Utah lawmakers said they’ve gotten assurances that the Trump administration would sign off. Still, it would be the first state in the country to get such a waiver.
If the waiver isn’t approved, the state Senate proposal would repeal the expansion altogether, though lawmakers say that provision could change in the future.
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