House Bill 391, which nullifies Utah's participation in health care reform and prevents Gov. Gary Herbert from negotiating with the feds on Medicaid expansion, is a legislative temper tantrum that needs to be defeated. As this is written, its fate is still uncertain.
There is a thoughtful way for states to deal with a planned expansion of Medicaid that is supposed to provide health care to uninsured Utahns. The Affordable Care Act, also known as Obamacare, would provide Medicaid to about 130,000 Utahns who don't have health insurance. The feds would provide 100 percent of the funding at first, and then 90 percent of the funding.
Gov. Gary Herbert understands that the growth of Medicaid is one reason for Utah to take its time on the Obamacare proposal. Medicaid costs are close to 20 percent of the budget. The cost savings that Obamacare's Medicaid adds would provide could be eliminated if there are no serious cost controls on the program, whatever the subsidies provided by the feds. Also, there are stringent bureaucratic requirements attached to Obamacare's state Medicaid expansion that could hamstring its intentions.
The governor wants more time to talk to the feds to craft the state's Medicaid plan as Obamacare would define it. Time is needed. Avoiding participation in the new federal health care law essentially throws scores of thousands of Utahns out of health care reform. Dealing with the costs, social and monetary, of treating these uninsured Utahns will not go away.
Legislators who are supporting HB391 are not seeking to improve the quality of lives for their constituents who need access to health care insurance. Rather, they are politicking. Trying to nullify Obamacare, which is the law of the land, is ultimately an impotent move.
HB391 is likely an unconstitutional move. It's demagoguery designed as political cheerleading, not sensible governing. Let the governor work the details out; he's the mature one on this issue.