Gov. Gary Herbert
Utah's Republican Gov. Gary Herbert appears to have inched closer to securing a waiver from the Obama administration for Medicaid expansion this week, though details—and sign-off from the heavily Republican legislature—still need to be ironed out. The basic issue is a proposed work requirement the Republican lawmakers demand and which the administration would not approve. Herbert
says that the administration has agreed to the concept that Medicaid recipients should work with the state to find work (ignoring the fact that many if not most of the newly eligible people are actually working their asses off in low-paying jobs).
The governor said after a meeting with Sylvia Burwell, secretary of the Department of Health and Human Services, that a final agreement is two or three weeks away.
HHS did not agree that insurance subsidies would be contingent on recipients holding a job or looking for work, but the agency did agree that employment can be a goal of Utah’s program, Healthy Utah.
"It’s a win, win, win all the way around," the governor said, describing the negotiations as resulting in federal approval of 95 percent of his Healthy Utah plan.
Herbert's Health Department director, David Patton,
calls the agreement a "breakthrough," but is more cautionary than his boss. Burwell has given the nod to keep talking about some kind of work provision, but what that's going to look like is still very much up for discussion. What Herbert can get his legislature to agree to and what the administration will swallow could still be miles apart. Nonetheless, the governor's team—including Republican Rep. Jim Dunnigan—is claiming that they are 95 percent of the way to an agreement with the administration.
There are about 111,000 people who could gain coverage with the expansion, including 60,000 who are in the Medicaid gap—making too much to qualify for the state's traditional Medicaid program and too little to qualify for a subsidy to buy insurance on the exchange. Herbert is considering calling for a special session to get some sort of bridge program in place for these people while the state continues to work out the details of its waiver with the feds.
So one more red state is at least lurching toward that evil, evil Obamacare, just as long as they can appropriately stigmatize the 111,000 people who need access as lazy bums that the state has to force into employment. The good news, though, is that one more red state is lurching toward doing the right thing by its people.