Utah gov defies voters, signs limited Medicaid expansion

Utah’s governor on Monday signed legislation into law a limited Medicaid expansion plan, defying voters who approved a full expansion in November.

The bill signed by Gov. Gary Herbert (R) would cover far fewer people, and cost taxpayers more money, than the plan voters approved in November.

The new law calls for the state to ask the Trump administration for permission to launch a partial expansion of Medicaid for people earning up to 100 percent of the poverty level, rather than the 138 percent under ObamaCare.

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In a statement, Herbert said the measure “balances Utah’s sense of compassion and frugality. It is now time to set aside differences and move forward to get those in greatest need enrolled on Medicaid and on the federal health care exchanges.”

The new plan is set to be implemented beginning April 1.

In November, voters narrowly approved Proposition 3, which called for full expansion. The new plan signed Monday effectively replaces the voter-approved measure with one that’s much more narrowly focused.

Anyone earning between 100 and 138 percent of the federal poverty level will have to purchase coverage on the federal exchange.

Proposition 3 would have covered 150,000 people, and would have been paid for by an increase in the sales tax.

The new law will cover about 48,000 fewer people, and will cost $50 million more than full expansion, according to a state analysis. It includes a cap on enrollment if costs are greater than expected, as well as a requirement that would remove coverage from people that don’t meet a work requirement.

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The law relies on the Trump administration giving Utah billions of dollars to expand coverage to only a fraction of the people called for under the law, a request the Centers for Medicare and Medicaid Services has denied in the past.

Still, state legislators have told reporters they are confident the waiver will be approved. If it’s not, the legislation calls for the program to revert to the full expansion approved in November, with certain restrictions.

Herbert is the second governor to defy his state’s voters on Medicaid expansion. Maine passed an expansion ballot measure in 2017, but former Gov. Paul LePage (R) fought the measure for over a year until he left office last month.

Newly-elected Democratic Gov. Janet Mills has since implemented the expansion.