Governor unveiled an alternative plan to Medicaid expansion – The “Healthy Utah Plan” fixes the hole without expanding Medicaid

SALT LAKE CITY – (Feb. 27, 2014) Utah Governor Gary R. Herbert wants the federal government to block grant Utah the money it would give for Medicaid expansion, allowing the state to administer its own program.

“My job as governor is to make sure Utahns get the full economic benefit from their taxes,” said Gov. Herbert. “I am not recommending an expansion of the federal Medicaid program. However, I am prepared to pursue a block grant from the federal government to bring Utah taxpayer dollars back to our state to fulfill our responsibility to care for the poorest among us.”

As outlined by Governor Herbert, the “Healthy Utah Plan” would seek a state innovations waiver that would allow the state to use a block grant to support the three-year pilot program.

During this three-year pilot program, the state will use the block grant funds to provide help to Utahns who make under $15,500 a year. Healthy Utah will provide assistance to pay for health insurance in private markets. The exact amount of assistance will depend on four factors:

  • ability to work
  • household income
  • access to employer or family health insurance
  • and individual health care needs

All participants in Healthy Utah would be responsible to make co-payments to help pay for the cost of their care. In addition, parents with children on Medicaid would have the option to put their entire family on private insurance plans.

“Family life these days is difficult enough without trying to manage health care through multiple networks with multiple sets of rules,” said Gov. Herbert.

The Utah Department of Health would closely monitor the pilot program and report to the Utah Governor’s Office and the Legislature to determine how best to proceed based on outcomes and the federal government’s ability and willingness to meet its funding obligations.

The governor’s Healthy Utah Plan not only includes his ideas, but also incorporates the best elements of both the Senate and House plans. It also follows the four principles the governor outlined in his State of the State address: 1) individual responsibility; 2) support private markets; 3) maximize state flexibility in administering federal programs; and 4) serve the best interests of the Utah taxpayer (see Health Care Guiding Principle Fact Sheet).