Federal Government Denies Utah Plan for Partial Expansion

By Sheldon Weisgrau | Aug. 8, 2019

Last month we wrote about interest from some Kansas legislators in the so-called “Utah model” of Medicaid expansion. Utah proposed a partial Medicaid expansion, in which coverage would be extended only to 100% of the federal poverty level (FPL) – $12,490 for an individual and $21,330 for a family of three – rather than 138% FPL – $17,236 for an individual and $29,435 for a family of three – as required by federal law.

Utah requested that the requirement for full expansion be waived so the state could receive the enhanced 90% federal funding that comes with the program. Otherwise, Utah would receive only its standard federal match rate of 68%, resulting in a partial expansion that would cost the state more, but cover fewer people than a full expansion.

Utah’s proposal also included other unprecedented provisions, such as caps on enrollment and spending, that had never before been approved and are seemingly in conflict with federal law. These gimmicks are the latest in a long line of plans and proposals that opponents of Medicaid expansion have embraced in an effort to erect barriers to health coverage for low-income individuals.

As predicted, it didn’t work. Utah officials were informed by the federal government last week that the state’s waiver proposal would not be approved. Partial expansion thus joins work requirements, an idea which has been repeatedly rejected in court, in the trash heap of bad and illegal Medicaid schemes. Utah will now presumably implement its fallback plan – full expansion as mandated by the state’s voters.

There’s a lesson for Kansas legislators in the experience of Utah (and Arkansas, Kentucky and New Hampshire, which have had work requirements overturned in court). It’s the same lesson we wrote about last month: forgo gimmicks like the Utah model, which may seem attractive, but in reality cost more, cover fewer people and will induce costly litigation that the state is likely to lose.

Instead, Kansas lawmakers should pass a full KanCare expansion that provides tens of thousands of hard working Kansans with health coverage, brings our federal tax dollars back home and supports our rural communities.

Sheldon Weisgrau is the Alliance for a Healthy Kansas’ Senior Policy Advisor. Contact Sheldon at sheldon@expandkancare.com.