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Feds Reject Utah Waiver Request For Partial Medicaid Expansion

Health-care advocates are pushing the Utah Legislature to approve a full Medicaid expansion under the Affordable Care Act.

The Trump administration has rejected Utah's waiver request for enhanced federal funding for partial expansion of the state's Medicaid program.
Advocates of full Medicaid expansion say it's an opportunity for state lawmakers to fulfill the wishes of voters, who passed a referendum last November expanding Medicaid to some 150,000 low-income Utahns. State lawmakers modified the referendum results to cover fewer people, but needed a federal waiver to implement their plan.

Stacy Stanford, a health-policy analyst with the Utah Health Policy Project, said lawmakers included a fallback plan in case their waiver was denied.

"With the fiscal adjustments that we put into this fallback plan, the full extension is more than solvent," she said. "They're paying three times more now. There's no need for that; there's no need to delay. They should move forward with pursuing the full expansion."

Under the Affordable Care Act, states can expand Medicaid with the federal government picking up most of the tab. But after Utah legislators failed to approve an expansion, a coalition of health-care advocates gathered signatures and put the expansion on last year's ballot. 

However, lawmakers set aside the referendum and passed House Bill 96, a limited expansion that would have covered 90,000 people.

Despite lawmakers' protests that a full expansion would obligate the state for future costs, Stanford said the referendum contains a fiscally responsible way to pay for it. 

"We passed a funding mechanism with the ballot initiative," she said. "There is a small increase in the non-food sales tax, and so there's more than enough through that sales tax to cover the projected enrollees."

Stanford said the next step for her group is a rally Thursday afternoon at the Capitol Rotunda in Salt Lake City.

"We were in the middle of the public comment period of the waiver when it was rejected," she said. "We're sitting on 6,000 public comments - and so, we're going to display these messages from Utahns that are calling for full expansion."

According to House Bill 96, legislators must now decide whether to accept the full expansion or call a special session to come up with a different plan. 

Details of HB 96 are online at