Full Medicaid expansion could go to voters to decide in November 2018

SALT LAKE CITY — On Monday, a group of nonprofit organizations will file a new ballot initiative with Utah’s Lieutenant Governor to fully expand Medicaid under the Affordable Care Act, also known as Obamacare. 

If enough signatures are gathered in support of the initiative, Utah voters will get the chance to vote on the issue in November 2018.

“It would be full Medicaid expansion that would close the coverage gaps in Utah, covering about 80,000 people who are currently in that gap,” said Jason Stevenson, Education and Communications director for Utah Health Policy Project. “Altogether, it would cover 127,.000 Utahns, and would go up to 138 percent of the federal poverty level.”

RELATED: Utah Democratic lawmaker renews push for full Medicaid expansion

The initiative will also help rural hospitals remain open, Stevenson added.

Households that earn 100 to 400 percent of the federal poverty level can get insurance subsidies under the Affordable Care Act. The law also has a Medicaid component to cover those below 100 percent of that line, but a U.S. Supreme Court decision left Medicaid expansion to the states to decide. So far the federal government has funded 100 percent of the ACA’s Medicaid component, but Utah refused to accept its portion, in part out of skepticism that the feds could pull the plug on funding and leave the state holding the bag.

Under the ACA, beginning in 2020 and beyond, states will be on the hook to fund 10 percent of Medicaid expansion, while the federal portion will drop to 90 percent. 

Utah is one of 19 non-expansion states. If approved by voters, Utah would join 31 states plus the District of Columbia in expanding Medicaid, a key part of the Affordable Care Act that enables everyone to acquire health care coverage.

“The ballot provision will have a funding element,” Stevenson said of the increase in sales tax from .047 percent to approximately .0486 percent — or roughly two cents for every $10 spent. “That money would go toward the state’s (10 percent) contribution for expanding Medicaid and would then leverage almost $700 million in federal funding that would support the expansion as well — money that we’re currently leaving on the table.”

The Utah Health Policy Project is joined by AARP, Voices for Utah Children and other groups who have been active in this issue for a long time, Stevenson said. Their efforts drew notice from several national groups, among them Families USA and The Fairness Project who have agreed to support the ballot initiative drive both logistically and financially.

Initiative sponsors include Sen. Brian Shiozawa, R-Cottonwood Heights; Karina Andelin Brown, a health care advocate from Logan; Beth Armstrong, a health clinic director from Park City; Alan Ormsby of the AARP in Salt Lake City; and Bishop Scott Hayashi, of Salt Lake City’s Episcopal Diocese.

Monday’s filing of the initiative application is just the first step of several in getting the measure on the ballot in Utah. Once submitted, Lt. Gov. Spencer Cox will review the application and either accept or reject it based on established criteria

Within three days of receiving the application, Cox will forward it to the Governor’s Office of Management and Budget, which will analyze its fiscal impact and issue an estimate within 25 days.

Initiative sponsors must then hold seven publicized public hearings in designated areas throughout the state. Ballot measures involving a tax increase must include those details in the published meeting notices.

Within 14 days after the public hearings have been held, initiative sponsors have the opportunity to tweak the text of their proposed law.

Finally, signature-gatherers can begin circulating petitions statewide to gather 113,143 voter signatures proportionately from at least 26 of the state’s 29 senate districts. Those signatures are due to county clerks for their review and verification by April 15, 2018.

A political issues committee and nonprofit named Utah Decides Healthcare will oversee the initiative campaign and accept donations to help fund the petition drive.

Sponsors of the Medicaid expansion initiative intend to officially announce the effort during a 1:30 p.m. press conference Monday in room 105 of the Utah State Capitol.

Contact reporter Cathy McKitrick at 801-625-4214 or cmckitrick@standard.net. Follow her on Twitter at @catmck.

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