Republican leaders have agreed to a broad, conceptual framework for expanding Medicaid to insure tens of thousands of low-income Utahns with a plan that would call on medical providers to pay for the new health coverage.
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Sources familiar with the conceptual agreement say it would require hospitals, doctors and pharmaceutical companies to help pay for the expanded coverage, possibly through a new tax. That money then would cover those Utahns living above the poverty level and unable to qualify for traditional Medicaid.
The new tax dollars — or money alternately saved through reducing existing Medicaid reimbursements — would be used as the state’s contribution to draw down nearly a billion dollars in federal money. After covering all of the cost the first year, federal reimbursement will be phased down, eventually covering 90 percent of the program.
The state then would tap the Medicaid funds to provide subsidized private health care coverage to as many as 126,500 Utahns who fall into what is known as the Medicaid gap.
But the tentative agreement is still preliminary with many moving parts. It would:
• Still require the state to get waivers from the U.S. Department of Health and Human Services to implement the program.
• Require at last some measure of buy-in from hospitals, doctors and pharmaceutical companies.
• Need to win the approval of the Legislature, particularly the House, which last session resoundingly defeated Herbert’s similar Healthy Utah plan.
If the new proposal is ultimately accepted, Utah would be the first state with a Republican-led Legislature and a GOP governor to expand Medicaid through a market-driven system.
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