Utah voters approved a ballot measure last year to enact full Medicaid expansion under the Affordable Care Act, bringing health care to 100,000 lower-income residents.
But that isn't the last word. A bloc of conservative state lawmakers, saying there isn't enough money to pay for the expansion, are looking to "repeal and replace" Proposition 3 with a less-ambitious plan.
While the state Constitution allows lawmakers to make changes to ballot initiatives, Chase Thomas, executive director of the progressive group Alliance for a Better Utah, said this alternative plan seems designed to thwart the will of the voters.
"We understand small changes, to implement the propositions into existing law and also just to make them feasible," he said. "What we don't support are changes that implement new policy or change the policy desires of the people."
Thomas said legislators trying to limit the the Medicaid expansion are the same ones who have blocked it in the past. Their claim is that Prop 3 won't generate enough revenue for the program, but Thomas pointed to hundreds of millions of dollars in the state's surplus fund. Conservatives had proposed limited Medicaid expansion, contingent on federal officials granting the state a waiver, which it has failed to get.
According to Thomas, a bill expected in the upcoming session would drop Medicaid eligibility rates from 138 percent to 100 percent of the federal poverty level, add a work requirement for many people and extend the launch date well past April 1.
"Medicaid expansion, as we all know, is not a new discussion," he said. "It's been around for six years now, and they have been worried about costs. But the people wanted full Medicaid expansion, and they even increased taxes on themselves to fund it."
Under Utah law, Thomas said, ballot propositions can be modified or even repealed by the Legislature but at lawmakers' political peril. He said Utah voters bypassed lawmakers on three progressive issues this past November.
"We had medical marijuana, Medicaid expansion and redistricting reform all on the ballot, and they've been coming up in the Legislature every single year for the past four to six years," he said. "It's just these high-profile progressive issues where the public wants to move faster than the Legislature's willing to do."
The new General Session starts on Monday.
Information on Prop 3 is online at ballotpedia.org.