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Gov. Gary R. Herbert, R-Utah, testifies about his state's experience with the Medicaid program. February, 2011.
Gov. Gary Herbert

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.

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.

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.

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.

Originally posted to Joan McCarter on Wed Apr 16, 2014 at 12:40 PM PDT.

Also republished by Obamacare Saves Lives and Daily Kos.

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Comment Preferences

  •  Tip Jar (14+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Wed Apr 16, 2014 at 12:40:52 PM PDT

  •  But then again, in a state that is that heavily (0+ / 0-)

    Mormon, sometimes basic decency will surprise.

    Maybe.

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

    by zenbassoon on Wed Apr 16, 2014 at 01:02:29 PM PDT

    •  Rarely (0+ / 0-)

      Conservatism is a far more powerful force in Utah politics than Mormonism. I recently witnessed this tug-of-war in regards to immigration.

      Conservative groups were, of course, foaming at the mouth, hoping to pass an Arizona-style papers-please law, while the Mormon establishment was quietly supporting a very beneficial guest-worker program.

      The papers-please folks WERE narrowly defeated, but the proposals to work out some solutions for dealing with undocumented labor were absolutely crushed.

      Make no mistake: in regards to healthcare Herbert is one of the few moderate politicians in the state.

      The only way he might get a healthcare expansion passed is if he can make it look like a cash cow for either Utah government or Utah business (hence the heavily privatized nature of the plan).

    •  The Mormon church doesn't believe (1+ / 0-)
      Recommended by:
      Things Come Undone

      In letting its members use government benefits. When a dam broke in southern Idaho and thousands of people lost their homes, the church told its members not to take federal money, but to rely on the church charities. I think the idea is that if you only turn to the church you will have no allegiance to the state. So I am sure they don't want Medicaid money for their members.

      Be bold. Be courageous. Americans are counting on you. Gabby Giffords.

      by Leftleaner on Wed Apr 16, 2014 at 02:30:15 PM PDT

      [ Parent ]

      •  Which is great if you're a Mormon (0+ / 0-)

        But if not? Don't we have a separation clause in the constitution? Kowtowing to the LDS is a losing proposition. Screw this deal and let Utah and its religious leader come to their senses.

        What stronger breast-plate than a heart untainted! Thrice is he arm'd, that hath his quarrel just; And he but naked, though lock'd up in steel, Whose conscience with injustice is corrupted. Henry VI Part II Act 3 Scene 2

        by TerryDarc on Thu Apr 17, 2014 at 05:24:49 PM PDT

        [ Parent ]

      •  If you don't cowtow to the LDS (1+ / 0-)
        Recommended by:
        Matt Z

        in Utah you're basically screwed. They use their billions like a sledge hammer to control people. I know several former LDS members who have had to basically give up on any state anything once leaving the nuthouse. The LDS in Utah IS the law for all intents and purposes.

        Jesus only performs miracles for people with enough time on their hands to make that crap up.

        by KneecapBuster on Thu Apr 17, 2014 at 08:35:41 PM PDT

        [ Parent ]

    •  This is not basic decency (1+ / 0-)
      Recommended by:
      mjd in florida

      This is nearly the same raw deal that Gov. Mike Pence of Indiana is trying to get permission for with the equally grotesquely named Healthy Indiana Plan. In both cases the plans violate long-standing rules on what constitutes Medicaid, particularly the punitive requirement for the poor to pay for part of their coverage.

      I want to know whether Sebelius really said that there was no problem, or whether this is just another lying Republican lie.

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Wed Apr 16, 2014 at 07:26:27 PM PDT

      [ Parent ]

      •  Healthy Indiana has been around long before (1+ / 0-)
        Recommended by:
        dinotrac

        the ACA.

        "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

        by zenbassoon on Wed Apr 16, 2014 at 08:10:20 PM PDT

        [ Parent ]

        •  And it was terrible the whole time (1+ / 0-)
          Recommended by:
          TerryDarc

          But Pence is trying to get a fake Medicaid expansion in the same terms as Utah.

          Back off, man. I'm a logician.—GOPBusters™

          by Mokurai on Wed Apr 16, 2014 at 08:29:02 PM PDT

          [ Parent ]

          •  Does the medicaid expansion plans have to meet (0+ / 0-)

            certain criteria such as coverage and costs?

            If I'm HHS, I'd say "It's got to do everything Medicaid does for the same price to the patient."

            "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

            by zenbassoon on Wed Apr 16, 2014 at 08:51:44 PM PDT

            [ Parent ]

          •  In what way is it terrible? (0+ / 0-)

            I would have thought that anything helping people to get health care would be better than nothing, and, by definition, better than terrible.

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Thu Apr 17, 2014 at 05:26:02 PM PDT

            [ Parent ]

            •  The total number of enrollees is capped, (1+ / 0-)
              Recommended by:
              dinotrac

              the income limit is absurdly low, and they have to pay part of the cost of care.

              So, yes, better than nothing, but a terrible excuse for a Medicaid program.

              Even the right wing, when whining and lying about Obamacare, makes the case against Gov. Mike Pence and the Healthy Indiana Plan (HIP).

              The Daily Caller: Obamacare kicks 11,000 poor residents off Indiana health plan

              Part of Gov. Mike Pence’s agreement with the Obama administration lowered the maximum income level for eligibility from 200 percent of the federal poverty level (FPL) to 100 percent.
              Medicaid.gov/Eligibility
              The Affordable Care Act of 2010, signed by President Obama on March 23, 2010, creates a national Medicaid minimum eligibility level of 133% of the federal poverty level ($29,700 for a family of four in 2011) for nearly all Americans under age 65.

              Back off, man. I'm a logician.—GOPBusters™

              by Mokurai on Thu Apr 17, 2014 at 10:53:36 PM PDT

              [ Parent ]

  •  So the poor will subsidize private insurance (4+ / 0-)

    What is the point of making the poor have to pay extra for private insurance, when you can offer the same thing for free with Medicaid expansion?

    This is essentially making Medicaid pay out the same benefits but charge the poor $420 a year to pad insurance companies profits.

    I am open to some reforms like requiring a modest copay for non-emergency use of emergency rooms.  At least that makes an honest attempt to cut some waste in the system.

    But most of the GOP waiver request are about being a dick to the poor.  This just makes the program less efficient with more red tape, while passing costs to those who can least afford it.

    •  It is the Republican perversion of (1+ / 0-)
      Recommended by:
      leighkidd

      personal responsibility, which always claims that taking benefits away from the poor or making them pay for their benefits is morally good for them.

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Wed Apr 16, 2014 at 08:32:41 PM PDT

      [ Parent ]

    •  You have to be almost literally penniless ... (0+ / 0-)

      To not be able to afford $35/month (which is $420/yr). That's doable on minimum wage, welfare, or just about any form of poverty. There's no reason for it, of course, other than screw-Obama, but it's not some huge hurdle.

  •  As a disabled person (3+ / 0-)
    Recommended by:
    mjd in florida, paulex, TofG

    (major visual impairment) a "work requirement" for Medicaid strikes me as beyond malicious to malevolent.

    Pay no attention to the upward redistribution of wealth!

    by ActivistGuy on Thu Apr 17, 2014 at 04:43:32 PM PDT

  •  I hope some telling statistics come out before (1+ / 0-)
    Recommended by:
    TofG

    the election in November, that compares states that have the Medicaid expansion with states that refused it. Then maybe connections can be made between that and the Kochs and ALEC and the GOP.

  •  Is Herbert a bad guy here, or is he working to (0+ / 0-)

    come up with something his legislature will accept?

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Thu Apr 17, 2014 at 05:23:30 PM PDT

  •  Utah is another state I am not going into (0+ / 0-)

    I can't stand hypocrisy.  I so dislike the creeps who did all they could to prevent Americans from having healthcare to have their hand out when they see it is what people need.  Where were you?  In a cave?

    I will not go to Utah again although we used to go there often to the Family History Library.  I am finished with their all-for-us and-none-for-the-government-we-take-more-from-than-give-to rhetoric.  I'm done.  Finished with Utah.

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