Trump administration approves Utah's plan to subvert the will of voters on Medicaid expansion

Utah was one of three states in which voters decided to expand Medicaid on the 2018 ballot, along with Idaho and Nebraska. Because Utah is ruled by Republicans, the legislature and governor didn't just take the people's will to have clean Medicaid expansion as provided under the Affordable Care Act and implement it; they insisted on scaling it back AND putting work requirements on top of it. Friday, the Trump administration approved the state's waiver to do that.

The state will be allowed to cap enrollment in the program if the state runs out of money. That means it will cover some 60,000 fewer people than clean expansion would have, and even more infuriating for the good people of Utah, "cost the state tens of millions of dollars more." That's because it is really expensive for a state to pile on administrative levels to figure out who to cut out of the program and to monitor the employment of those in it.

In attempting to circumvent another lawsuit like the ones that resulted in Arkansas' and Kentucky's work requirements being struck down this week, the Trump administration inserted language in the approval letter saying that "Members of the Adult Expansion Population, absent the demonstration, would be ineligible for any Medicaid benefits, and absent approval of the amendment, would be eligible only for highly limited benefits." In other words, it does expand coverage versus what the state was doing before, so now it does comply with the Medicaid statute and underlying purpose.