SALT LAKE CITY (AP) — Hundreds of demonstrators rallied at the Utah Capitol on Monday to shield a voter-approved Medicaid expansion from lawmakers’ efforts to change the measure to control costs.
Changes could delay the expected April 1 rollout for months or years, leaving people without health care that could save lives, advocates said.
Activist Paul Gibbs said Medicaid has been essential to kidney treatments that total tens of thousands of dollars.
“The voters of Utah made a choice to care for their fellow human beings,” he said to the crowd of about 300 at the rally held hours after the 2019 session opened. “No one has the right to take that away.”
State leaders who long refused to expand Medicaid said they will implement the measure that won at the ballot box, but have to make changes to control costs. They point to a state budget analysis that found the program could fall $10.4 million short by the year 2021.
A proposal by Republican Sen. Allen Christensen of North Ogden would cap enrollment and include a work requirement, changes requiring a potentially lengthy approval process from the federal government. For expansion supporters, that would “amount to a repeal,” said Stacy Stanford with the Utah Health Policy Project.
Another bill sponsored by Republican Sen. Jake Anderegg would repeal the measure altogether.
Voters also approved a sales tax increase that is expected to generate $90 million, and Stanford said the state should roll out the program with that money and make any future adjustments as needed. Full Medicaid expansion will also bring $800 million in federal money back to the state.
Most lawmakers are committed to covering people who make up to 138 percent of the poverty level, Republican Senate President Stuart Adams said. But “we have to do it in a fiscally prudent way,” he said.
Democrats, on the other hand, want to keep the law largely as passed by the voters, with some minor tweaks.
State law allows the Legislature to change the language of laws passed by voters at any time.
Advocates got the issue on the ballot after the GOP-dominated legislature refused to fully expand Medicaid under President Barack Obama’s signature health care law, citing cost concerns.
The plan approved by voters provides health care coverage to an estimated 150,000 low-income Utah residents. An analysis from the Governor’s Office of Management and Budget found that in 2021, the sale tax increase would bring in $92.8 million, less than needed to cover the $103.2 million the program is expected to cost the state.
Utah is one of three Republican-leaning states where full Medicaid expansion won the vote in November after years of resistance from state lawmakers.
In Idaho, Republican Gov. Brad Little has also voiced the possibility of a work requirement or work training. In Nebraska, the rollout is on track despite some lingering concern from lawmakers.
Utah state leaders also highlighted other key issues as the session opened. New Utah House Speaker Brad Wilson said that if lawmakers don’t fix the state’s tax structure, the state general fund could run short within a few years, leaving it unable to fund roads, public safety and other government programs.
Restructuring to tax more services will also allow the state to cut taxes overall by $225 million, he said, an estimate that tops Republican Gov. Gary Herbert’s plan for a $200 million tax cut.