SALT LAKE CITY — The Trump administration on Friday approved the first step in Utah lawmakers’ contentious plan for a partial Medicaid expansion.
The state will begin taking applications Monday to cover an additional 70,000 to 90,000 more people, far fewer than the full Medicaid expansion approved by voters in November.
Republican lawmakers said they had to scale back the program to control costs, but advocates said the change undermined the vote and reduced access to needed health care.
Seema Verma, administrator of the Centers for Medicare and Medicaid, praised the plan as “a sustainable Utah solution that extends coverage while helping to lift families from poverty instead of trapping them in public assistance.”
Advocates with the group Utah Decides, on the other hand, called the scaled-back plan a “backroom deal,” that cut 50,000 people from the number that would have been eligible for Medicaid.
Verma’s agency also approved an enrollment cap and a work requirement, though the latter won’t go into effect until January. Though federal judges blocked work requirements for two other states earlier this week, Republican Utah Rep. Jim Dunnigan said his state’s plan is different because people could meet it by trying to find work, training or caring for children so someone else could work.
“It’s a much lower bar,” he said.
The Monday expansion will cover persons making less than $12,500.
The ballot measure would have fully expanded Medicaid under the Affordable Care Act to people making less than $17,200 a year.
Voters also approved a sales tax increase to pay for the expansion, but a subsequent state analysis found it would fall short in a few years.
Those not covered under lawmakers’ partial expansion can still buy heavily subsidized insurance on the federal health care marketplace.
The state will pay millions to fund its share of the expansion now, but submit a second waiver request asking the federal government to increase its portion of the funding as promised to states that expand Medicaid under former President Barack Obama’s health care law.
That second waiver is expected to be a tougher request, since no other state has gotten approval to receive the increased federal money without fully expanding Medicaid.
Lawmakers have said they have been assured that request will be approved, but if it isn’t approved by July 2020 the state would revert back to much of the full Medicaid expansion originally approved by voters.