An internal debate is brewing within conservative lawmaking circles. On one side is a philosophical purity that believes government spending is out of control, on the other side is $430 Million that has already been paid to Utah by the Federal Government.
What is causing this heartburn? Medicaid expansion. If Utah’s Republican-dominated government refuses the money and returns it to the Federal Government, it won’t do anything to reduce the debt. However, by doing so, an estimated 53,800 Utahns will be missing out on desperately needed medical care.
“I don’t agree with big deficits, but I want to make sure that patients get the care they need – for the first time in years, we have the opportunity to help a population that has not been served,” says Republican Senator Brian Shiozawa, an emergency physician for the past 20 years. “I don’t want us to be sitting as a ‘lone’ state while citizens in other states receive it – it is the pragmatic thing to do.”
Cherilyn Eagar, speaking as a representative of the conservative Eagle Forum, claims that the Federal Government has put Utah, and other states, in an unfair and inequitable situation. “We as states should stand up and tell the Feds that, if we pay into the system, we should be able to pull funds out for the things we want and not be placed into an ‘all or nothing’ situation.”
Eagar also raises concerns about the long term ramifications of accepting Medicaid funds, which she says are only going to come in over the next three years, and that the state will have to pick up the bill or reduce the number of those covered in order to balance budgets.
According to the Affordable Care Act, if Utah were to accept the Medicaid funds and provide the insurance for its citizens, the Federal Government will fully fund the program for 3 years, after which Utah would be required to pay a portion of the bill while the Federal Government funds the rest.
Democrats appear to be far less conflicted on the issue.
“I say we take the money and run.” Says Senator Jim Dabakis. Representative Larry Wiley agreed, adding that “it gives us an opportunity to take care of current problems. Having sat on the Social Services Appropriations Subcommittee in the past, I can tell you that difficult decisions have to be made picking and choosing what gets funded.”
Ultimately, the decision will come down to Governor Gary Herbert. Currently Utah is one of only seven states yet to decide if it will accept Medicaid funds. Nationally, 25 states, including Utah neighbors Arizona, Colorado, Nevada, and New Mexico, have accepted or are leaning towards accepting their states portion of the funds. 13 states, including Idaho have chosen not to participate, with 5 states (including Wyoming) leaning towards that direction.