Utah's Republican Gov. Gary Herbert says he thinks there aren't major hurdles now for Utah to get a federal waiver to offer a version of a privatized Medicaid expansion under Obamacare. Herbert met with Health and Human Services Secretary Kathleen Sebelius this week, and says she told him "I see nothing here [in the state's application that would be a deal breaker."
Herbert is pitching the Obama administration on allowing a waiver under the Affordable Care Act through a plan Herbert calls Healthy Utah. His idea would be for the federal government to hand over the $258 million per year that would have gone to expanding Medicaid for low-income Utahns and let the state instead subsidize private insurance for those who qualify.There's a potential deal breaker in the proposal, however, that has derailed another state's attempt to get a waiver: a work requirement for recipients. Pennsylvania Gov. Tom Corbett was denied his first attempt at a waiver in part because it had a work requirement for beneficiaries, a proposal he's now dropped from his waiver request. The administration has been pretty reluctant to tie punitive measures like work requirements, or drug testing, or lifetime limits on benefits—things that stigmatize the program and its enrollees—to expansion efforts. Both the work requirement and the copays for even the poorest of families could end up dooming the request.
The governor’s plan includes covering the estimated 111,000 Utahns who are at or below 138 percent of the poverty level. Subsidies for the recipients would vary depending on household income, ability to work, access to other insurance and health-care needs. The recipients would have to contribute about $420 a year on average toward their ultimate health-care costs. […]
The Centers for Medicaid and Medicare Services declined to comment on Tuesday.
Given all that, Herbert might be unduly optimistic on getting the waiver. But if he does, he still has the Republican legislature to contend with, and they've not proven to be particularly amenable to any plan to get coverage for the 110,000 people who've fallen through the gap.