Utah Republicans undo voter-approved Medicaid expansion

Utah Gov. Gary Herbert speaks to members of the media during a news conference at the Utah State Capitol, in Salt Lake City, Feb. 5, 2015. (Photo by Rick Bowmer/AP)
Utah Gov. Gary Herbert speaks to members of the media during a news conference at the Utah State Capitol, in Salt Lake City, Feb. 5, 2015. 

Republican officials in a variety of states responded to 2018 election results by taking steps to undermine voters' will, but GOP officials in Utah went a little further than most.

It was just a few months ago when a majority of Utahans approved Proposition 3, which expanded Medicaid under the Affordable Care Act, and added Utah to the list of 37 states (including D.C.) that have done the same thing.

Yesterday, as the Salt Lake Tribune  reported, the state's Republican policymakers undid the policy their own constituents tried to implement.

Utah's voter-approved Medicaid expansion initiative was replaced Monday with a program that is more restrictive, initially more costly, and contingent on a series of uncertain federal concessions. [...]Senators voted 22-7 to adopt the House version of SB96, which launches a partial medicaid expansion April 1 and would revert to full expansion only in the event that federal administrators reject multiple requests for Affordable Care Act waivers.

Gov. Gary Herbert (R) wasted no time and signed the measure into law as soon as it cleared the state legislature.

The Center on Budget and Policy Priorities published a brief report last week, explaining that the voter-approved policy would extend Medicaid coverage to roughly 150,000 low-income Utahns. The new Republican replacement, however, will cover "48,000 fewer Utahans and would cost the state $50 million more over the next two years."

That's not a typo. The GOP policy, at least over the next couple of years, will cost more and do less. (Republicans hope to make up the difference in the long run by covering fewer people.)

Complicating matters, as we discussed last week, the GOP plan includes an awkward trigger mechanism: Utah would request waivers from federal officials, seeking permission to apply harsh and unprecedented eligibility restrictions. If federal officials balk, under the Republican proposal, the entire Medicaid expansion initiative would immediately disappear.

Circling back to our earlier coverage,  at face value, the legislative effort reflects an obvious hostility toward health care benefits, but let’s not miss the forest for the trees: it also points to antagonism toward democracy. Voters in Utah approved Medicaid expansion. Republican policymakers in Utah responded by effectively asking those same voters, “Who put you in charge?”

The day after the midterm elections, I took note of the significant progress voters made on health care. Apparently, I didn’t fully account for Republicans’ willingness to defy voters’ will.