What is going on with Medicaid, anyway?

July 29th, 2019|Issue Update|0 Comments

You have likely heard the news by now that the Trump administration plans on denying the waiver that was being prepared for submission by the Utah Department of Health.

The entire situation can be confusing, and it is hard to know how to feel about it, so here is a short breakdown:

During the 2019 legislative session, the legislature passed SB 96 to supersede the voter approved proposition to expand Medicaid. You can read the breakdown of that complex bill here.

While the Utah Department of Health has spent an extraordinary amount of time trying to create the waiver, including holding public hearings for comment, and they still plan on submitting the waiver, as of Friday when the news broke, the next steps in the event of a denial were clearly laid out in the 4th substitute of SB 96. This substitute included a couple of stopgap measures just in case of a denial like the one we are getting.

Per the language of the bill:
A waiver application will be submitted requesting the federal government pay a 90/10 share to cover the limited expansion (up to 100% FPL) with work requirements, enrollment caps and lifetime caps. Unlike the previous version of the bill, if the waiver fails to be approved by January 1, 2020, Medicaid will be expanded to cover people earning up to 138% of the FPL, and a new waiver will be submitted, asking for a 90/10 match with a work requirement for enrollees and other cost containment functions, such as enrollment caps and per capita caps.

To be clear, we see this as a good thing. First of all, we get to expand Medicaid to include people making up to 138% of federal poverty line, a move that lots of states have done before. We don’t have to ask for any special permissions to do that. Second, having the denial so soon allows us to move forward more quickly to get people coverage.

What can you do?

Call your legislator and ask them to uphold the full Medicaid expansion per the stopgap measures included in SB 96.
Don’t know who represents you? You can find that information here.

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