As Utah rolled out its partial Medicaid expansion Monday, health care advocates said they’re worried the scaled-back version of a voter-approved law will leave thousands of people behind.
While they’re glad more people will get coverage, they’re worried about people such as Leonard Bagalwa, a refugee from the Democratic Republic of the Congo.
“Making enough money to survive is not always easy for us,” Bagalwa said. He would have been covered by Medicaid under the full expansion approved by voters, but his salary puts his family of six just over the poverty line, so he isn’t eligible under the scaled-back version of the law.
He can buy subsidized private insurance under exchanges created by former President Barack Obama’s health care law, but the plans still aren’t affordable for him and his wife. “I am the very person the Legislature’s new expansion cut off,” said Bagalwa, who advocated for the full-expansion law.
The Trump administration approved the first step in the program Friday, allowing the state to begin enrolling people who make less than $12,500. The partial expansion is expected to cover up to 90,000 people; the voter-approved law would have expanded coverage to some 150,000 people making less than about $17,200.
Lawmakers argued those changes were needed to keep costs under control long term.
“I think the voters in my district want to help lower-income Utahns out in a way that’s fiscally responsible and sustainable for the state,” said Republican Rep. Jim Dunnigan, who sponsored the scaled-back plan and is facing a new campaign to unseat him from the health care advocacy group Utah Decides.
Meanwhile, people who still can’t get Medicaid can buy “terrific health care” for a “very modest amount,” on the federal exchanges, he said.
Advocates said that while that’s true for some healthy people, plans on the exchanges created under the Affordable Care Act aren’t affordable for everyone. Also, some people who had expected to be covered under Medicaid have missed the deadline to enroll in the exchanges.
“This is really affecting people. The people falling through these gaps have real issues right now,” said Stacy Stanford with the Utah Health Policy Project.
The state also wants to add work requirements, which are concerning to advocates because they would require extra reporting and could end up leaving some people off the rolls for missing paperwork, Stanford said.
The Trump administration approved Utah’s first step in the program last week, which also included an “unprecedented,” enrollment cap that lets authorities stop putting new people on the program based on state funding decisions, said Jessica Schubel with the Center on Budget and Policy Priorities.
Utah’s next step of asking for increased federal funding even though they’re not covering everyone specified under Obama’s health law will be closely watched, she said.