Voters passed Prop 3 to fully expand Medicaid, but legislators passed a replacement bill (SB 96) to significantly alter Prop 3 by reducing the number of covered individuals and including work requirements and per capita caps. These changes require the state to file for waivers to ask the federal government for permission to implement all alterations that are inconsistent with current federal guidelines. That includes a waiver specifically to request per capita caps.
As part of the waiver process, the state Department of Health is required to collect public feedback. Public hearings have already been held, but the window for submitting written comments is still open! As of June 17, no written comments had yet been submitted to the state. That means YOUR VOICE IS NEEDED! This is your chance to weigh in on Medicaid expansion under SB 96! But you must hurry. Public comments are due JUNE 30TH!
WHAT YOU CAN DO
- Submit a public comment directly, either online here or via email at Medicaid1115waiver@utah.gov. Utah Health Policy Project is also collecting Medicaid stories that will be entered in as public comment. If you would like to submit your health care story through UHPP, click here.
What should your public comments say?
The DOH is required to implement the law (S.B. 96) and will not be able to implement the full expansion plan as passed by voters via the Prop 3 ballot initiative. That means Utah’s Medicaid expansion will cover 70,000-90,000 people ages 19-64, rather than the 150,000 that would have been covered by Prop 3’s full Medicaid expansion. Public comments may:
- address any concerns about how the Department has interpreted SB 96, as well as if they feel the Department should make changes in response to that
- make note of whether or not you feel Senate Bill 96 was the appropriate way to move forward
- address any concerns about per capita caps, or other specifics of SB 96, such as work requirements
These concerns will be recorded and submitted as part of this process.
Do public comments matter?
- YES! Public comment is an important formal step in the 1115 waiver process. Since SB 96–the Medicaid replacement bill–is requesting provisions that are usually not allowed under Medicaid law, the state must go through a complicated approval process. Part of that process includes collecting, reviewing, and responding to comments from the public.
- Public comments have recently been used in litigation against work reporting requirements and have made a real difference in getting those harmful red tape barriers overturned in Arkansas and Kentucky. Likewise, Utah’s comments will play a role in any upcoming legal challenges.
What is a Per Capita Cap?
This is a mechanism that limits the amount of federal dollars that can come in to the state for the Medicaid program. This is good for predicting federal spending on Medicaid, but bad for the states, as the caps do not allow for increases in health care costs, which currently are rising at a very rapid rate.
Why is it a problem?
Under a per capita cap structure, the state receives a limited amount of federal dollars (like in a block grant), and in exchange, receives permission to make cuts to Medicaid that are normally not allowable.
Per capita caps make it harder to provide services during emergencies or economic recession
Per capita caps negatively impact the people who need services the most, such as low-income seniors and people with disabilities. (You can read more about per capita caps here.)
To learn more about Medicaid expansion or apply for Medicaid, click here.