Governor's health plan is best deal, new analysis says


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SALT LAKE CITY — A new Medicaid expansion analysis calling Gov. Gary Herbert's Healthy Utah plan "far more advantageous" to the state than the more limited House alternative, Utah Cares, sparked sharp debate Tuesday.

"The economics here, the cost-benefit analysis, is not very complicated," said Sven Wilson, chief economist at Notalys, the consulting firm that produced the report for AARP Utah, Voices for Utah Children and the Utah Health Policy Project.

Wilson, a BYU professor, said "the only rational thing to conclude" is that opponents of the governor's plan to provide health care to low-income Utahns are "afraid that we're going to have a successful program."

He said that would be a tough sell to "kind of the radical elements in the party who are pushing against any kind of use of expansion dollars" available to the state under President Barack Obama's signature health care law.

But House Majority Leader Jim Dunnigan, R-Taylorsville, dismissed the report as "a rerun of a TV show that was on last season," and called it "biased" against his Utah Cares plan, citing "editorializing" in favor of the governor's proposal.

Dunnigan also said the suggestion that lawmakers haven't accepted Healthy Utah because they fear its success is "just silly" and "so far away from the truth it doesn't deserve a response."

The back and forth comes as a six-member group that includes House and Senate leaders put together by the GOP governor nears a self-imposed July 31 deadline for coming up with a plan they can all support.

"We are optimistic we will reach a resolution soon," the governor's spokesman, Marty Carpenter, said in a statement that also expressed appreciation for "the passion and support of many Utahns, who are anxious to see a final decision."

Dunnigan, however, said the group, which is meeting privately, will likely only have a "concept" by then. He did not rule out having a plan in place that could be considered in a special session of the Legislature later this year.

The majority leader said the group has moved on from both Healthy Utah and Utah Cares and is looking at long-term solutions, including a possible tax on hospitals to cover costs.

Utah Hospital Association President and CEO Greg Bell told the Deseret News the organization continues to be willing to pay up to $25 million in taxes annually assessed according to Medicaid use.

The $25 million has been "offered since day one," Bell said, although lawmakers have pressed for more revenue from hospitals. Bell, a former lieutenant governor, said legislators could look to restoring some of the sales tax on food to raise funds.

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Dunnigan said putting back the state's share of sales tax on food is not being considered.

Until lawmakers take action on a plan, an estimated 66,000 Utahns remain in the so-called coverage gap because those earning below the federal poverty level do not qualify for any government subsidies.

The report said Healthy Utah, which would qualify for the largest federal match, by providing coverage to residents earning below 138 percent of the federal poverty level, would bring $912 million to the state over two years and cost $37 million.

In contrast, because Utah Cares would take care of fewer low-income residents, the state would have to pick up 30 percent of the cost, $84 million, while receiving a smaller federal match, $345 million, the report stated.

The two plans were compared with similar results during the 2015 Legislature, but the governor's plan stalled in the House over concerns about the sustainability of Healthy Utah.

Wilson said the numbers tell "a simple story, in that both programs have benefits that signficantly exceed their costs," but the margin is much bigger with Healthy Utah, which also costs less and has lower risks.

He said Utah taxpayers are already contributing to the costs of the Affordable Care Act, and to "reject the benefits that come out of this program we're already paying for" is like protesting the federal government by refusing a tax refund.

"There is nothing conservative, or cautious, or fiscally responsible about throwing money away, which is what we're doing on the order of $50 million a month for 18 months," the economist said.

Because the federal government initially covers all of the cost, Wilson said even if more Utahns end up using Healthy Utah than expected, the state would still see a higher return on its investment than the Utah Cares alternative.

AARP Utah Advocacy Director Danny Harris stressed the report was not intended "to bash one plan or the other. Our intent was to try to provide an illustration of which direction is going to be most beneficial to our state."

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Lisa Riley Roche

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