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Guest opinion: Use the $300 million sitting in Medicaid fund

By Kathy Adams - | Feb 24, 2024

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Kathy Adams

On Feb. 6 during the House Business and Labor Committee meeting, Rep. Norm Thurston (District 62) diminished the good intentions of fellow Republican Rep. Ray Ward (Bountiful), a physician whose bill would have provided Medicaid coverage for more pregnant women living in poverty. Thurston, an academic with an Ivy League education and the executive director of a health data company, managed to sound befuddled enough to create the impression that there were too many ways for women living in poverty to receive prenatal care. Thurston even insulted doctors’ intentions, insinuating Ward and other physicians were greedy. Despite every single public comment at the hearing speaking in favor of the bill, the committee stripped out the provision expanding obstetrics care for pregnant women living in poverty.

Thurston claimed in a quote to KSL News that low-income women already “have access to health plans through their employers or the Affordable Care Act,” even after admitting that women can only apply for ACA obstetric care during an annual 10-week enrollment period. If you’re talented enough to get pregnant within those 10 weeks, you’re good — otherwise not. Thurston’s other fantasy about employers, health care plans and low-wage workers is clearly a view from a perch of privilege. Low-wage jobs do not offer health care plans. Ultimately, a woman has the option of quitting her job so she can qualify for Medicaid or keep working for low pay, in which case she can’t afford health insurance.

Thurston described Medicaid as “state” money that he can’t just be giving it away. In fact, voters passed Medicaid expansion on a statewide referendum. That money accumulates each year, now at $300 million sitting in an account unused that Ward’s bill would tap into — requiring no other funding or tax increase. Yet Thurston’s personal hostility toward doctors and low-income women keeps your tax money sitting there.

Thurston alleged that doctors only want pregnant women to receive Medicaid for prenatal care to make a quick buck. Doctors who care for patients covered by Medicaid do so because they recognize that they and their unborn child deserve the same consideration as those who are more affluent. If an OB’s practice was entirely Medicaid based, they’d go out of business because the reimbursement rate wouldn’t be enough to cover the practice’s overhead and malpractice insurance.

Thurston’s refusal to spend the fund on its intended purpose impacts hospitals too. Patients who aren’t insured and don’t receive prenatal care tend to have worse outcomes. Bad outcomes end up costing the state more, because (as Thurston fails to mention) the baby will be covered by Medicaid after it’s born, and a complicated birth could potentially cost millions for a single birth. So either the hospital eats the cost (driving up health care costs in general) and/or the hospital corporation sends a debt collector, exacerbating the No. 1 reason for bankruptcy in Utah — medical debt.

Thurston might be an Ivy League economist, but his numbers don’t add up to common sense. Making Rep. Ward’s bill whole again is the practical choice.

Kathy Adams was the dance writer at the Salt Lake Tribune (2002-2019) and has written about dance for Salt Lake Magazine, Dance Magazine, Dance Teacher Magazine and more.


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