Utah Access Plus Medicaid Expansion Proposal

[Update: Utah Access+ couldn't get enough votes to move forward.

Lets see, the Utah House GOP earlier this year was willing to invest $30 Million for Utah Cares, coupled with a 70/30 split would be $100 Million total to help the poor adults with health care. The kids are already eligible. That wasn't enough.

The Governor wanted Healthy Utah where the state would need $80 Million with the 90/10 split, but the $80 Million wasn't funded.

UtahAccess+ funds the $80 Million with the $30 Million from the state and $50 million from the health care providers, as new taxes and fees. What killed UtahAccess+, or likely did, was Greg Bell saying the Hospitals, who would make tens if not hundreds of millions a year on either Healthy Utah or Utah Access+, didn't want it if there was no cap other than the 6%.

They were willing to pay $25 Million total and if it was more, they weren't.

So, go back to Utah Cares, there are the votes and the funding for it. It covers those that can't make money because they need health care and more. 


[Original Post] 

Should Utah do something? Yes. The Federal Government, in the attempt to make sure everyone can have medical insurance has made it worse. What we should do re: Medicaid expansion is what we do in other areas where people need help. 

We should provide short term aid and work to provide a long term solution. Prove caps on time and money. Do not take away individual responsibility. This isn't Medicare, something that everyone retiring has to deal with. This is Medicaid, something that was designed for those that can't afford other options. ObamaCare trying to make more people fall into that category isn't the answer.

Don't Expand Medicaid in Utah. Do care, Do provide short term aid and work to solve the long term solution.

The Utah Access+ bill isn't final, but what is being proposed at this time is covered in the following documents:

http://www.fredcox4utah.com/UtahAccess1.pdf


http://www.fredcox4utah.com/UtahAccess2.pdf

http://www.fredcox4utah.com/UtahAccess3.pdf

A almost Draft Bill for Utah Access+ is at:
http://le.utah.gov/documents/medicaidExpansion.pdf



Earlier this year I voted for a proposal called Utah Cares. A copy of that bill is here:

http://le.utah.gov/~2015/bills/static/HB0446.html

The Cost to the State Taxpayers would eventually be approx. $30 Million per year.
We have people that can't work because they need health care and don't make enough money to qualify for help. Those are the ones we need to focus on and encourage people to make more money, not less. 

The other main proposal was called Healthy Utah.
http://le.utah.gov/~2015/bills/static/SB0164.html


The cost to the State Taxpayers for Healthy Utah would eventually be approx. $80 Million per year, would have no cap for budgeting, would cover people not in the "Coverage Gap", and would expand medicare to 138% of poverty level.

Currently on Medicaid or Chip, children are covered, as are adults with children under 50% are covered and approved disabled adults under 100%.

The largest healthcare coverage gap are for
adults that are not disabled under 100% of poverty and
adults with children between 50% and 100% of poverty. (The Children are covered)

Adults over 100% of poverty, but under 400%  qualify for subsidy plans through ObamaCare.

The only reason to expand Medicaid to 138% is so the state will get a 90/10 Federal/State split on the cost of the expansion population medical costs vs the 70/30 Federal/State split we currently pay and will continue to pay for the non expansion population medical costs. The 90/10 Split would allow Utah to provide coverage for more people using more Federal dollars.

Healthy Utah crossed the 100% of poverty line and would have moved those between 100% and 138% to Medicaid. Utah Access+ does the same thing. The biggest difference is the cost.

Utah Access+ uses about $30 Million in State money, similar to Utah Cares, but adds approx. $50 Million in new taxes to the Medical field. Many of those with the new taxes would benefit from the new federal money but not all.

I oppose the new $50 Million in taxes. I oppose expanding Medicaid to 138% of poverty.

Federally, we can revise solve many of the healthcare problems without ObamaCare. Expanding Medicaid under ObamaCare is the wrong direction.

We can help people that can't work because they need health care and don't make enough money to qualify for help, without expanding Medicare. I am working to move the discussion back to Utah Cares and that focus. A step, not as big as some want, but a step none the less is the correct approach.

To take the stand that it is all or nothing that the Governor did with Healthy Utah and now Utah Access+ with the $50 Million in new taxes and fees is just wrong.

No to Medicaid Expansion

I was asked this last town hall about Medicaid Expansion and how I would have voted. I said they didn't have the answer and I wouldn't have voted for them. I was less than clear about what I would have proposed.

Two of the proposed bills are found here:

http://le.utah.gov/~2014/bills/static/SB0251.html

 http://le.utah.gov/~2014/bills/static/SB0272.html

If you look at the fiscal notes for the bills, you will see that taxpayers would pay between $250 Million to $750 Million, a year, much of it from Federal money, as subsidized by Federal Debt.

 This shows what plans are being considered:
http://youtu.be/0Om4HY6defw




Under the US Constitution, Art. 1, Section 8, the Federal Government should not be providing "ObamaCare". or even Medicare and Medicaid.

However, millions of taxpayers have paid in to Medicare for decades and have been promised services. This is something that can not be undone simply. You can't simply unmake the promises. Most individuals can not get any medical insurance other than Medicare when they retire, other than a supplement. Former Sen. Dan Liljenquist helped in 2011 solve similar problems for Utah by simply telling new state employees that the old plans were not available because we could not afford them, providing what we could and not going back on past promises to existing employees.

Many individuals now find themselves without insurance or the ability to get it because of ObamaCare. A medical insurance plan I looked at over a year ago is now 2 to 3 times more per month because of ObamaCare. When the Federal Government "Helps" and makes things worse, does Utah get involved? That is the question.

At the Town Hall, one candidate quoted some good principles I have heard many times before. They involve the incentive to help people to stay healthy and the lower cost of care and insurance if they do. I hadn't heard the source before, but they had been quoted by Rep.Dean Sanpei many times in trying to make sure Utah didn't go bankrupt dealing with Medicaid, and Federal programs that are not fully funded by the Federal Government. During 2011 and 2012, I voted for several of his ideas.

Rep. Dean Sanpei
http://le.utah.gov/house2/detail.jsp?i=SANPED

 Rep. Sanpei is an Assistant Vice President, Intermountain Health Care (Planning)

The advantage of having members of the legislature from all walks of live, is there are doctors, pharmacists, bus drivers, farmers, ranchers, attorneys, insurance agents, etc. You have to weigh where their conflicts are as well as where their expertise is.

I don't mean to make light of the principles brought up at the town hall meeting. They don't go to the main point of the discussion.

If the US Supreme Court has stated that Utah does not have to expand Medicaid under "ObamaCare" why should we? If ObamaCare is going to be torn down as a failure in the next couple of years, why should Utah create more problems and make it worse?

A recent Op-ED on this subject:
 http://www.deseretnews.com/article/865598235/Utah7s-financial-model-should-not-include-Medicaid-expansion.html?pg=all


What happened this last session is here:

http://www.sltrib.com/sltrib/politics/57671190-90/federal-state-coverage-expansion.html.csp

More information.
http://www.washingtonpost.com/blogs/wonkblog/wp/2014/03/28/utah-already-won-a-key-obamacare-concession-can-it-win-another/

Should Utah do something? Yes. The Federal Government, in the attempt to make sure everyone can have medical insurance has made it worse. What we should do re: Medicaid expansion is what we do in other areas where people need help. 

We should provide short term aid and work to provide a long term solution. Prove caps on time and money. Do not take away individual responsibility. This isn't Medicare, something that everyone retiring has to deal with. This is Medicaid, something that was designed for those that can't afford other options. ObamaCare trying to make more people fall into that category isn't the answer.

Don't Expand Medicaid in Utah. Do care, Do provide short term aid and work to solve the long term solution.

Fred C. Cox, Running for the Utah House of Representatives, District 30