Herbert optimistic about Medicaid talks

Monday , March 17, 2014 - 11:43 PM

Lieutenant Governor Resigns

Gov. Gary Herbert...

Michelle L. Price, The Associated Press

SALT LAKE CITY — Gov. Gary Herbert said he is optimistic as he deploys staff to Washington, D.C. this week for Medicaid negotiations. The Republican governor said last week he believes that federal officials may be open to his alternative plan to expand the Medicaid program.

The governor has not detailed specifically what his staff is pushing for, but he’s said he wants a plan that gives Utah flexibility and covers those in need while requiring them to contribute, such as by helping to pay costs or working if they are able.

While federal officials have rejected terms such as work requirements, Herbert said in an interview Thursday that he’s encouraged by early talks with federal officials about his plan to cover 110,000 low-income Utah residents with a federal block grant.

“I’m not going at this blind, just a hope and a prayer,” he said Thursday, hours before the Legislature’s 2014 session wrapped up. “We’ve already done some discussions. We’ve already had some vetting.”

Instead of enrolling more of Utah’s poor on the state-federal health care program, Herbert is seeking a grant of federal dollars to help those residents buy private health coverage.

Following the negotiations starting this week, Herbert plans to travel to Washington next month to continue the discussion.

Under President Barack Obama’s health care law, the federal government is offering to pick up the full cost through 2016 for states that expand eligibility for their Medicaid programs to people earning up to 138 percent of the federal poverty level. After that, reimbursement levels will gradually fall to 90 percent by 2020.

It’s unclear if federal officials will approve Herbert’s plan, which appears to seek millions of federal dollars without strings attached, or if they’ll settle on another program.

The Obama administration has approved similar “private option” alternatives in states like Arkansas.

Anything radically different will likely not win approval, according to Matt Salo, executive director of the National Association of Medicaid Directors.

Mike Fierberg, a regional spokesman for the Centers for Medicare and Medicaid Services, said in an email Monday that the agency has no comment on the pending discussion and will not comment on any proposals until they’ve reached a written agreement.

Herbert said from his discussions with other governors and recent offers of flexibility from Obama and federal officials, he’s “cautiously optimistic” they’ll come to an agreement.

“I don’t think this is going to be as hard a sell as some people think,” Herbert said. “Who knows? There’s no guarantee. But I think I’ve got about an 80 percent chance of success.”

Besides convincing federal officials, Herbert will have to bring Utah’s Republican controlled Legislature on board to approve a plan.

It’s too soon to say if Herbert will have something ready for them to consider before lawmakers convene again next January.

Utah legislators failed to adopt any Medicaid expansion plan before wrapping up their 2014 session last week.

While Democrats are pushing for a full, traditional expansion, Republican lawmakers offered up several options of their own about halfway through the session but failed to unite behind a single plan before adjourning Thursday night.

In the House, Speaker Becky Lockhart, R-Provo, and other GOP leaders were opposed to taking any federal money. They instead floated a proposal to use about $30 million to $35 million in state dollars.

They, like most other Republicans lawmakers, have cited concerns that the federal government may not hold up its end of the deal down the road.

In the Senate, Republicans moved to incorporate Herbert’s plan as a contingency option in their proposal to partially expand the program.

Herbert noted that thus far, legislators have not adopted any plan that tied his hands before working out a deal with the federal government, which is all he was seeking.

“I’m not worried about selling it to the Legislature,” Herbert said. “But our challenge is really getting back to Washington, D.C. and making sure the Obama administration is sold on it.”

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