Fallback Fallout: A look at the harmful provisions in Utah’s new “Fallback” Medicaid expansion proposal, the impact on kids & families, and what you can do

04 October 2019 Published in What's New?

For those following the Legislature’s multi-step 'repleal and replace' of Proposition 3, Full Medicaid Expansion, Utah is now moving onto its third phase of Senate Bill 96. As a reminder…

Phase 1: Senate Bill 96 directs Utah to pay more money to only partially expand Medicaid. On April 1st, Utah partially expanded Medicaid (up to 100% of the federal poverty level) but receives fewer federal dollars to do so. The upside is that Medicaid is currently OPEN for individuals up to 100% FPL. But the downside is that every month, Utah is losing money to cover FEWER people; money that could be spent keeping kids covered or helping families get enrolled.

Phase 2: State officials, at the direction of Senate Bill 96, attempted to get more money from the federal government to cover fewer people. The federal government rejected this waiver.

Phase 3: State officials are now proposing to cover more people through Medicaid (those up to 138% of the federal poverty level), which will help more individuals get coverage-- also called the “fallback” plan. Utah will receive more federal dollars by expanding up to 138% FPL. But Utah is also proposing to impose additional restrictions, barriers, red-tape and other harmful provisions for Medicaid enrollees. Those most targeted are the newly eligible individuals making approximately $12,000-$17,000 every year.

Research shows that adding on additional barriers, extra costs, penalties and restrictions for enrollees ultimately keeps eligible individuals from getting enrolled and staying enrolled. At a time when the number of adults and children without insurance is actually increasing, we should be doing all we can to help eligible people get enrolled and stay enrolled, instead of enacting policies which undermine this new coverage opportunity. You can see the full list of proposed changes here.

While we are encouraged to see Utah take a step closer to expanding Medicaid fully, we are disheartened that the “fallback” plan includes such harsh restrictions, which will hurt families and the Medicaid program going forward.

Let’s not forget: Utah voters supported a straightforward full Medicaid expansion, without extra penalties or restrictions, without harmful provisions that create more barriers to coverage and care.

What can you do?

Tell state leaders to implement full Medicaid expansion now, without harmful barriers or restrictions.

Submit your comment today or attend (or call into) a public comment hearing:

Monday, October 7th, 4-6pm at 195 N 1950 W, Salt Lake City, Utah – room 1020 C
Thursday, October 10th, 2-4pm, 288 N 1460 W, Salt Lake City, Utah- room 125

1-877-820-7831, passcode 378804#.

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