Utahns With Undiagnosed Disabilities Could Remain Without Medicaid Coverage Under House Bill

Jul 26, 2018

Some people without health insurance will avoid going to the doctor or hospital because they're worried they won't be able to pay the bills.
Credit Vic/Flickr

There are two possibilities for expanding Medicaid in Utah. A House bill that has been signed by Governor Gary Herbert, and a ballot initiative called Proposition 3.  

Shannon Rhodes is a medical social worker for Intermountain Healthcare. She attended a town hall meeting in Logan recently, where lawmakers and health care advocacy group organizers discussed Medicaid expansion.

"We had an instance where a lady, she noticed a lump underneath her breast and was concerned about it," Rhodes said. "She kind of delayed going [to the hospital] because she didn’t have insurance. And by the time she got there, it had become a stage four breast cancer that spread to other parts of her body. She later passed away."

According to Utah Public Health Data, in 2016 about nine percent of Utahns did not have health insurance. This health insurance coverage gap is what Medicaid expansion seeks to address. According to the writers of Proposition 3, all Utah citizens in the coverage gap will have access to Medicaid—covering an additional 150,000 Utahns. The House bill has a work requirement and would cover about 90,000 Utahns.

Not everyone who needs Medicaid is able to work, and the process for proving an inability to work can be long and daunting.

"As far as this bill I don’t know what kind of proof they would want to provide," Rhodes said. "What I do know is with Medicare, most people are denied the first time they apply for disability."

Rhodes said she doesn’t know why so many people are denied the first time they apply for disability, but that in her work experience it is common for people who genuinely can’t work to be denied coverage.

"I think it’s hard to paint a picture of how sick someone is on paper," Rhodes said. "And that’s the only thing that Medicare/Medicaid can go off of, is what they’re seeing on paper. But if you go into their home and see how long it takes them to come and answer the door, or how long it takes them to stand up, and walk to the bathroom, then I think you get a better picture of how disabled these people are."

Republican Representative Robert Spendlove—the sponsor of the House bill—said he is confident people who can’t work but don’t currently have insurance or Medicaid coverage will be able to get help from the Department of Health, but otherwise didn’t include a plan within the bill for people who haven’t secured disability coverage.