Coalition encourages Gov. Herbert to talk more about Medicaid Expansion

Nov 14 2013 - 1:33pm

A coalition of low-income advocates urged Utah Gov. Gary Herbert Wednesday to let Utahns know the fiscal impact that his rejection or acceptance of Medicaid Expansion funds will have on vulnerable households.

"Few decisions in our state's history will have as much impact as Utah's decision whether or not to expand Medicaid to cover 123,000 low-income adults under the provisions of the Affordable Care Act," the Nov. 13 letter from the Family Investment Coalition said.

It would not only be morally responsible to accept the federal funding, but it also makes good fiscal sense, the letter said.

The coalition encouraged Herbert to release two budgets for fiscal year 2015, one reflecting the financial impact of rejecting the expansion, the other "the estimated $11 million in savings ... if the state accepts the federal government's offer."

"Utahns need to be informed of the lost opportunity if the state rejects Medicaid Expansion this year," the letter said.

A report commissioned by the Utah Department of Health projected that expanding Medicaid could provide coverage for 123,000 uninsured Utahns and save the state $11 million in 2015. After three years, full federal funding of the expansion tapers off but never falls below 90 percent of the cost.

John Grima, a retired hospital administrator who serves on the board of Midtown Community Health Center, views the expansion as "something that could be of great benefit to our patients."

Midtown operates clinics in Ogden and Clearfield.

"It would give them access to a range of services, particularly specialty services, that Midtown does not offer," Grima said, noting that many of their clients are among the working poor, are children, elderly or have disabilities.

The uninsured can only tap specialty services on a charity basis, Grima added, which takes "perseverance and a fair amount of luck."

Specialty services run the gamut from cancer treatments to surgery, visits to cardiologists, neurologists and endocrinologists, to name a few.

"If you're a young adult, have a seizure disorder, and need a neurologist to manage it, that's a problem for you," Grima said. The same goes for a 55-year-old with heart disease, he added.

About 24,000 uninsured clients rely on Midtown for medical care, Grima said, projecting that up to half of those would qualify for Medicaid under the expansion.

In October, state Sen. Jim Dabakis, D-Salt Lake City, wrote Herbert and asked that he accept Utah's share, arguing that the funds have already come out of in-state paychecks in the form of taxes. As chair of the state Democratic Party, Dabakis urged Herbert not to succumb to political pressure on the right to reject the program.

In medical crises, the uninsured often end up in expensive emergency rooms due to lack of other options.

Ben Pales, a respiratory therapist who chairs the Weber County Democratic Party, challenged Herbert to offer a viable alternative to that status quo if he rejects the expansion.

"While Obamacare is not the best I think we could do, at least its a start," Pales said. "I'd like to see everyone covered eventually, and this is just a step in the right direction."

Sen. Allen Christensen, R-North Ogden, heads up the Health Reform Task Force that Gov. Herbert established to study Utah's options under the new law.

Last month, the panel reported on five options, which could be narrowed to a single recommendation when members meet next on Capitol Hill Thursday at 8 a.m.

"The $11 million is another government promise," Christensen said, voicing skepticism as to whether those dollars would actually materialize.

"The feds are making promises they aren't going to be able to keep, and we'll be stuck with it."

Christensen said he prefers no expansion. Instead, he'd rather enlarge Utah's Financially Assisted Care and Treatment System (FACTS).

"We call it charity care, and many are adverse to that term," Christensen said.

The Affordable Care Act already removes several roadblocks to accessing Medicaid, Christensen added.

"More will be on Medicaid, many more will be insured supposedly," Christensen said, "and that leaves many less who are uninsured. We'd like to expand our FACT network to cover them as well."

The Family Investment Coalition consists of the AARP, American Association of University Women, Community Action Partnership of Utah, Comunidades Unidas, Legislative Coalition for People with Disabilities, New Frontiers for Families, The Road Home, Salt Lake Catholic Diocese, Salt Lake Community Action Partnership, Utahns Against Hunger, Utah Health Policy Project, Utah Housing Coalition, Utah Statewide Independent Lving Council, Voices for Utah Children, and Your Community Connection.

Contact reporter Cathy McKitrick at 801-625-4214 or Follow her on Twitter at @catmck.

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