Fully expand Medicaid to truly help needy Utahns
Senator Gene Davis recently had an Op-Ed published in the Salt Lake Tribune (March 10th, 2015). EMAIL HIM
This Op-Ed explains his position concerning the several health care bills that have been brought before the legislature this session. As the session ended without any resolution concerning health care, we, as the Utah Senate Democrats, want you share this Op-Ed with you.
Below is Senator Gene Davis’ Op-Ed in it’s entirety.
As the Utah Legislature winds down, one major issue remains before us — deciding if and how the state of Utah will provide access to health care for those at the lower end of the economic scale.
Before us is Healthy Utah, a program that many have touted as the solution. Healthy Utah provides health care coverage to 199,000 people with federal tax dollars for two years and then dead-ends. At the end of
those two years,we will be putting thousands of lives in jeopardy as we will need to have the same debate we are having today — if and how Utah will provide access to health care for many of its citizens.
I recently had a conversation with a young woman who was gainfully employed and had access to health insurance from her employer. Then she became ill and, consequently, she lost her job. Now her only option for health care is through the emergency room, where she has amassed $250,000 in medical debt. She cannot afford the tests needed to diagnose her health problems. Many people find themselves in similar situations without access to needed health care. Healthy Utah, utilizing federal dollars for premium subsidies, would provide health insurance to many individuals; but my huge concern with Healthy Utah is the large amount of money needed for deductibles and co-pays, which results in large annual out-of-pocket expenses.
During this 2015 session, I offered Senate Bill 83, Robust Utah (full Medicaid expansion). This bill provides an ongoing program that allows access to Medicaid coverage for eligible individuals. In the state of Utah, 199,000 individuals would be able to access health care starting in 2016. Each year using 90 percent federal dollars and 10 percent Utah dollars, an average of $500 million (with a five-year total of nearly $3
billion) would be placed into the state’s economy. Under the Affordable Care Act, the state has the opportunity to accept the expansion of Medicaid (Robust Utah) and provide access for those living below 138
percent of the federal poverty line. That means a family of four with an annual income of $33,465 or under would be eligible. Healthy Utah, while covering the same number of people, essentially subsidizes the health insurance industry, requires enrollees to accumulate large amounts of out-of-pocket expenses, and dead-ends after two years.
I have proposed Robust Utah because I have noted Healthy Utah’s incredible downfalls. Robust Utah is all about access. Robust Utah provides health care access well into the future. It ensures that individuals who work hard can get the health care they need. Utah still has a consequential choice to make this legislative session. Do we, as a state, provide affordable health care coverage to Utah’s citizens, including the working
Sen. Gene Davis is a Democrat representing South Salt Lake and parts of Salt Lake City, West Valley City and Murray in the Utah Senate.
The time is now for Utah Medicaid expansion
State Senate President Wayne Niederhauser was recently quoted as saying that the new healthcare expansion framework he is developing "…holds out hope that Utah's compassion can harmonize with her common sense."
At first reading, this sounds like a wonderful thing: The ability to balance being caring and being responsible. Then I began to realize that he was speaking as though the two were not the same thing. In my eyes, being compassionate is common sense.
There are currently well over 100,000 Utahns who lack access to affordable health care as the state continues to stall action on Medicaid expansion. Many are right here in Washington County. The delay on taking action continues to have a daily impact on residents who are forced to rely on emergency rooms and clinics in order to receive even the most basic of care. Those costs could be prevented if we were to expand to provide easier access to preventative care.
Being stuck in a cycle of medical debt is a reality for many citizens here, regardless of politics or beliefs. More so than other debts, owing on healthcare bills only adds to stress rather than recovery. Daily calls and collection efforts create the impression that you are a failure, that you are not able to take care of yourself and your family. No one should have to worry that basic medical care is available for themselves and their loved ones. Making the decision between other expenses and your health should not be a choice we have to make.
Thirty states have already approved the expansion of Medicaid and are reaping the benefits of the much-needed funds to expand coverage to citizens who fall into the coverage gap. Utah would be the first GOP-controlled state in both the legislature and executive office to come to a compromise that would cover those on the lower end of wage earners.
Hopes of a passing bill have come and gone. It seems that regardless of who made the proposal, the state House had no intentions of approving a plan. The "Gang of 6" continues to negotiate a framework in conjunction with the federal government, but the time for change is now. No more talk, no more discussion. It's time to take action and get preventative and critical coverage for those who need it most.
Support is wide across the state. From emergency room doctors to state police chiefs and even the governor, who stated in a news article last January that "Doing nothing is not an option." Now, almost one year later, it seems that is exactly what we have done. I challenge the Republicans here in Washington County to reach out to the governor and ask him to take action and hold true to his promise.
The party here is trying to organize a demonstration to show our support for the expansion to all who should be eligible. Sen. Gene Davis has proposed a new plan, "Robust Utah," that would expand coverage to all those originally envisioned by the Affordable Care Act. Please contact me if you are interested in showing your support.
This should not be about national politics, it should be about common sense. And common sense can include compassion. Zachary Almaguer is chairman of the Washington County Democratic Party. Contact him at email@example.com.
LETTER TO THE EDITOR
Fully expanded Medicaid makes good sense for Utah
The simple idea that preventive healthcare always costs less than emergency care is at the heart of healthcare reform. If you are uninsured, you get emergency care; if insured, you get preventive care, and we reap the savings.
Taking such savings into account, the Congressional Budget Office now estimates that states who implement the Affordable Care Act with fully expanded Medicaid will break even or pay very little to benefit so many of their uninsured citizens.
We have heard the stories about medical emergencies that push working families over the edge into bankruptcy, poverty and hopelessness. According to Utah HHS, we are already paying for this emergency care and have forfeited over $400 million in federal funds, basically to other states.
Even a small obstacle like a $25 co-pay will result in increased emergency care costs rather than preventive care savings. Utah police support expanding Medicaid to cut crime by increasing access to mental health care and addiction treatment, which results in huge savings. http://www.sltrib.com/news/2526963-155/utah-police-cite-medicaid-expansion-as
Please urge your Utah state legislators to support fully expanding Medicaid (SB83 Robust Utah).
(See Salt Lake Tribune 3/10/15 or visit http://www.wcdpu.com/healthcare & sign the petition)
Chuck Goode (435) 229-8950 firstname.lastname@example.org Toquerville, Utah
gang of six agree to medicaid expansion, but house republicans still give resounding "no"
SALT LAKE CITY - 7/20/2015 - 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.
The so-called Gang of Six — Gov. Gary Herbert, Lt. Gov. Spencer Cox, Senate President Wayne Niederhauser, House Speaker Greg Hughes, House Majority Leader Jim Dunnigan and Sen. Brian Shiozawa — huddled this week constructing the skeleton of a new Medicaid plan to replace the governor's Healthy Utah and the House's Utah Cares proposals.
On Friday, they announced their agreement, saying it was sustainable and would protect other key areas of the budget.
"There is still work to be done," Herbert said in a statement, "but I believe we now have a framework in place that will provide care for Utahns most in need while being responsible with limited taxpayer funds."
Hughes, R-Draper, said the deal is in the best interest of all Utahns.
"If we can provide health coverage for those most in need while protecting other critical areas of our state budget, like public education," he said, "I believe we will have a model for other states to follow."
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.
"This agreement holds out hope that Utah's compassion can harmonize with her common sense," said Niederhauser, R-Sandy, "and be fiscally sustainable over the long term."
At a recent forum, Hughes suggested that, if hospitals are going to reap the windfall from the newly covered population, then maybe they should step up and pay the state's share. The House speaker went so far as to suggest maybe the state could stay out of the transaction entirely and the federal government could pay the providers directly.
Cox also liked the idea, but said at the time there were some technicalities to be worked through.
RyLee Curtis, an analyst with the Utah Health Policy Project, said she is pleased to see progress being made.
SALT LAKE CITY - 7/3/2015 — Lawmakers involved in the closed-door negotiations over Medicaid expansion acknowledged there is a chance the discussions will go past a self-imposed July 31 deadline.
“That’s still our objective. Time will tell if we achieve it. There’s still a lot of work to do,” House Majority Leader Jim Dunnigan, R-Taylorsville, told FOX 13 after briefing lawmakers on a Health Care Reform Task Force.
Asked if they don’t meet the deadline, Rep. Dunnigan said: “I expect we’ll keep working on it.”
The “gang of six,” comprised of Rep. Dunnigan, Gov. Gary Herbert, Lt. Gov. Spencer Cox, Senate President Wayne Niederhauser, House Speaker Greg Hughes, and Sen. Brian Shiozawa, have met numerous times since the end of the Utah State Legislature to try to hammer out a deal to provide health care coverage to thousands of Utah’s poor. The goal was to reach a compromise by the end of July and have a special session to approve the plan in August.
Members of the so-called “gang of six” meet with HHS Secretary Sylvia Burwell on April 29, 2015. (Photo courtesy the Utah Governor’s Office)
However, lawmakers noted that it’s still a work in progress. The group recently traveled to Washington, D.C., where they met with Health and Human Services Secretary Sylvia Burwell. Sen. Shiozawa told the task force on Thursday that the 90-minute meeting went well.
“They seem to be open to our waivers, or new waivers if we come up with different waivers,” he said.
While the Senate backed the governor’s “Healthy Utah” plan, the House wouldn’t agree to it, saying it was not sustainable for taxpayers in the long-run.
“We have to come up with a plan that’s sustainable,” Rep. Dunnigan said. “Unlike the federal government that doesn’t have to worry about balancing their budget, we do in Utah.”
Many lawmakers are also anxious to see if a U.S. Supreme Court ruling on portions of the Affordable Care Act will have an impact on their negotiations.
Meanwhile, advocates for the uninsured continued to hope for an agreement soon. RyLee Curtis, a senior policy analyst with the Utah Health Policy Project, said she was glad that lawmakers continued to talk — but noted that people are going daily without medical care and, in some cases, dying without coverage.
She pointed to Emily Young, an advocate who testified before lawmakers in support of expanded coverage, who died last year of cancer.
Emily Young testifies before lawmakers in this picture provided by the Utah Health Policy Project.
“I think it’s our duty to come to that solution and that we get these people coverage,” Curtis told FOX 13. “Because people are without health coverage. They’re losing their lives and they’re sick.”
Provo • Police Chief John King on Tuesday called for the Utah Legislature to accept federal funds to extend health insurance for thousands more state residents to prevent future crime, as well as save money.
King made his plea along with a representative of Fight Crime: Invest in Kids, an anti-crime organization that supports Gov. Gary Herbert's Healthy Utah expansion plan, which includes provisions for treatment of mental health issues.
"I'm not here as an expert on health care policy," King said at a news conference.
But as a law enforcement officer, the chief — who stressed that he and Fight Crime: Invest in Kids are not equating mental illness with criminality — said he knows the toll that mental illness, behavior disorders and substance abuse can take.
"It's a smart move," King said of expanding coverage.
Nearly 5,000 police chiefs, sheriffs, prosecutors, and violence survivors belong to the New York City-based Fight Crime: Invest in Kids, with more than 80 of the members in Utah. The group works to put research on how to reduce the risk of children becoming involved in crime when they grow up in the hands of policymakers and the public.
On Tuesday, the organization released a report — "Utah Law Enforcement Leaders: Our Officers Make that Knock on the Door" — that says some of the more than 1,200 deaths from car accidents, drug overdoes, suicides and homicide that occur in the state each year could be prevented by effective treatment of substance abuse and behavior disorders. (The report's title refers to the delivery of the message that a loved one isn't coming home because of some tragedy or the arrival of officers investigating a child abuse or neglect report).
State lawmakers are working to reach a compromise by the end of July to dueling Senate and House bills that would expand Medicaid, Healthy Utah and Utah Cares. Healthy Utah would cover thousands more than Utah Cares.
Brett Beckerson, senior associate of Fight Crime: Invest in Kids, said the governor's plan would be an important step forward and lead to "a safer, healthier Utah overall."
According to the report, parents without insurance are three times more likely to have uninsured kids. So when more parents get covered, more of the children in the state who are currently uninsured also will get coverage, the report says.
Juergen Korbanka, executive director of Wasatch Mental Health in Provo, said treating behavioral health issues is a logical extension of preventing crime.
He cited as an example a wife and mother who began using methamphetamine to deal with an underlying bipolar disorder, became an intravenous drug user, went to jail and had nowhere to go when she got out. When she qualified for Medicaid, she was able to get treatment and reconnect with her family, he said.
Salt Lake City Police Chief Chris Burbank had not seen the Fight Crime: Invest in Kids report but supports the group's mission. "Expansion of mental health treatment in any arena helps to reduce criminal activity and recidivism," he said.
Studies cited in the Fight Crime: Invest in Kids report say that having a mental illness in addition to an alcohol or drug disorder can increase the odds of engaging in violence by 26 times and that providing proven medical treatments for troubled youths can cut future arrests by at least half.
And an analysis of three treatment programs showed an average net savings to society of $25,000 to $31,000 for each youth served. The cost to incarcerate a juvenile in Utah is $39,000 for six months.
The report says that if Utah does not act to extend health coverage, the state will have to continue to pay for the "unabated costs" that come with untreated mental health and behavior disorder and the cost of incarcerating criminals.
And, the report says that "we in law enforcement will have to continue knocking on too many doors."