Utah’s approach to caring for the poor

Gov. Herbert met with Utahns who would benefit from his Healthy Utah alternative to Medicaid expansion.

Editor’s note: this post was authored by Dr. David Patton, executive director of the Utah Department of Health, and was originally published in the Salt Lake Tribune

A key component of health reform efforts, both nationally and locally, has always been providing access to appropriate, affordable health care for those who find such services beyond their reach.

For the better part of the last two decades, the default mechanism to provide health care for the poor has been to expand the federal Medicaid program. However, Utah Gov. Gary Herbert, along with several other governors – both Republican and Democrat – have challenged the conventional wisdom, finding better ways to extend health care coverage to the poor.

The Healthy Utah plan presented last week by Gov. Herbert combines the best of all options. Without expanding the federal Medicaid program, the governor’s proposal provides appropriate and affordable health care to Utah’s needy population by covering the 10 essential health benefits required by the Affordable Care Act.  However, by accepting the revenue as a block grant, Healthy Utah gives our state the flexibility to design a program best suited to meet our needs.

President Obama told the nation’s governors there is flexibility to design programs that are right for their states, but also provide access to care for their people. In fact, both Arkansas and Iowa received the green light to move forward with plans similar to what Gov. Herbert has proposed.

Healthy Utah promotes individual responsibility by requiring recipients to share in the costs of their health care. Those at the higher-end of the income range ($15,521 per year for an individual) will help pay their premiums and share some of the costs of their medical care. Those below the poverty line ($11,670 per year for an individual) will make modest co-payments – for example, $4 at their doctor’s office.

Another benefit of Healthy Utah is that it offers flexibility to families. Those with children currently enrolled in Medicaid would be given the option to include their children in the same plan their parents choose.

The plan encourages additional responsibility by requiring those benefit recipients in the program who can work, to work. Those seeking work will go through a skills assessment and enroll in employment training classes.

The Healthy Utah plan supports the private market. Rather than forcing recipients into the Medicaid program, they’ll use federal dollars to purchase private insurance.  Those who have affordable insurance at work will receive assistance to enroll in that plan.  Others will purchase qualified health plans through the individual market.  All plans will have cost sharing protections to ensure costs are appropriate for recipients at their individual income level.

Whether or not coverage is expanded, Utah residents and businesses are sending nearly $700 million in Obamacare taxes and penalties to the federal government each year. The governor’s plan respects those taxpayers by bringing as much of that money as possible back to Utah to care for the poor among us.

The governor’s plan also maximizes flexibility for both the state and the recipients who will enroll in the program. The state will outline its plan in a detailed proposal to the federal government and will negotiate with the federal government on the best way to implement and fund it.

Some have argued that the only way to accomplish health reform is to expand the traditional Medicaid program. They are wrong.  Gov. Herbert’s Healthy Utah plan helps Utah do the most good for the most people in need, while respecting the Utah taxpayer.