Utah’s Medicaid Expansion is Here! What it Means for Kids and Families

13 January 2020 Published in What's New?

    A quick recap of how Utah got to full Medicaid expansion:

In November 2018, voters approved Proposition 3 which fully expanded Medicaid for those up to 138% of the federal poverty level, drawing down extra federal funding for full expansion.

Then in February of 2018, the Governor signed S.B. 98 which repealed Proposition 3 and replaced it with a complicated, multi-phased plan:

Phase 1 directed Utah to adopt a partial Medicaid expansion (for those up to 100% of the federal poverty level). Partial expansion meant Utah could not access enhanced federal funds, so Utah was paying more to cover fewer people. On April 1, 2018, Utah’s partial expansion went into effect.

Phase 2 directed Utah to ask the Federal government to receive enhanced funds for its partial expansion and limit the number of people who could enroll in Medicaid. The federal government rejected Utah’s request to do this, triggering the third phase or ‘fallback plan’…

Phase 3 is happening NOW! Utah has fully expanded Medicaid up to 138% of the federal poverty level, tapping into the enhanced federal funds available, but also tacking on some additional harmful requirements like Medicaid work reporting requirements.

Confused how Utah ended up with full Medicaid Expansion on January 1st? Want to understand how Utah’s Medicaid expansion will affect kids and families? Read on…

First off, expansion means thousands of more parents are eligible for Medicaid! Now that Utah has expanded up to 138% of the federal poverty level, more families will be able to access affordable care. Utah is also able to access enhanced federal funds for Medicaid expansion, just as Utahns voted for in 2018. Here are some other highlights for kids & families:

  • Families can enroll in Medicaid anytime. A family should not worry that they missed an open enrollment period for Medicaid. There isn’t one! Medicaid is always open for families who need it. Families can call 2-1-1 to learn more.
  • New mothers will no longer lose Medicaid coverage 60 days postpartum. With expansion, mothers can maintain their Medicaid coverage to ensure consistency in postpartum coverage and care.
  • Young adults will have comprehensive Medicaid benefits, also called EPSDT benefits! This means more 19- and 20-year old’s will have benefits like dental care and mental health screenings. The Utah Department of Health had previously proposed to take this benefit away, but the federal government denied Utah’s request. Young adults will have access to these critical benefits!

When parents have coverage, their kids are more likely to be covered as well. As the number of uninsured kids in Utah continues to grow, we are hoping that full Medicaid expansion will help reverse this negative trend so more kids get connected with coverage.

But Unfortunately There are Work Requirements and Some Other Harmful Provisions too…

Unfortunately, Utah’s full Medicaid expansion is not exactly what voters supported in November 2018. This expansion also includes work reporting requirements. Utah’s work requirements, also called community engagement requirements, create an extra layer of red tape for families. Utah’s new reporting requirement will mean some parents will have to apply to 48 jobs over a 3 month period in order to keep their Medicaid benefit. Other states have found the biggest burden with work requirements are the complex reporting systems that parents must navigate in order to show compliance or prove an exemption. The majority of Utahns in Medicaid are already working or unable to work. Evidence from other states is clear: work requirements create extra red tape and system barriers causing eligible people to lose their Medicaid coverage.

The Utah Department of Health has also asked the federal government to approve a few other harmful changes to the Medicaid program. One of the most onerous new changes will be charging premiums to those individuals and parents making between 100-138% of the federal poverty level. Premiums are not only a financial burden for many parents, but they are also an administrative challenge to report. Similar to work reporting requirements, we unfortunately anticipate seeing many eligible parents lose coverage because of confusion and misinformation around premium payments. Utah is still waiting to see whether or not these additional Medicaid requirements, like premiums, will be approved by the federal government.

But these requirements should not deter individuals and parents from applying to Medicaid and getting the coverage they need now. Organizations like Take Care Utah are ready to help parents enroll and navigate work requirements or any other questions around Medicaid.

We can and will fight these harmful barriers to Utah Medicaid so families do not lose coverage- but coverage comes first! Expansion is here in Utah, finally.

Let’s make 2020 a year where more Utah parents and kids can get covered and stay covered!