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Utah Gets Federal OK for Full Medicaid Expansion Plan

Doctor with concerned face sits across from red-headed woman.

Federal officials have approved a modified waiver that will provide a full expansion of Medicaid in Utah, with work-reporting requirements. Last week federal officials approved the state's "fallback" plan, which will open up Medicaid coverage to about 60,000 more low-income Utahns.

That comes almost a year after Utah voters approved Proposition 3, an initiative directing the state to accept a full Medicaid expansion.

However, state lawmakers overturned that vote and replaced it with a plan to install a partial expansion. Stacy Stanford, a health policy analyst with the Utah Health Policy Project, said federal officials rejected the partial expansion, triggering a contingency or fallback plan that is part of S.B. 96, the enabling legislation.

“Full Medicaid expansion makes it so the only thing needed to qualify is to be poor enough,” Stanford said. “Utah has done that with some strings attached. So, if your income is low enough, you're in - if you can meet the work reporting requirement."

The expansion extends coverage to individuals making less than 17 thousand dollars a year, or families earning up to 35 thousand.

However, advocates such as the Utah Health Policy Project said work requirements could bump about 75-hundred or more Utahns from the rolls.

"They're kind of giving care with one hand but taking it away from some people with the other,” Stanford said.

Utah officials were paying 32 percent for the partial Medicaid program, but the state will receive the 90-10 match rate, and will cover more individuals at a lower cost. Stanford said the battle to expand Medicaid has cost Utah's taxpayers a lot.

"And then we've also lost so many human lives,” Stanford said. “There is a real human cost to this."

Stanford said her group and others will continue to fight against unnecessary waiver provisions sought by the state that do not contribute toward public health and make it harder for Utahns to get care.