News Release

Medicaid Expansion Scenarios Explained

July 16, 2018 (Salt Lake City) – The Kem C. Gardner Policy Institute today released a policy brief that provides a detailed description of three Medicaid scenarios facing Utahns. These scenarios include 1) the Medicaid waiver expansion passed in the 2018 General Legislative Session, which is still awaiting federal approval, 2) the Medicaid ballot initiative (Proposition 3: Utah Decides Healthcare Act) that will be on the November 2018 ballot, and 3) a default Primary Care Network benefit expansion should the other two scenarios not succeed. The Gardner Policy Institute prepared this brief to help Utah voters, policy makers, and business and community leaders better understand and compare the proposed changes to Utah’s Medicaid program.

“Medicaid policy options are complex to even those of us who work closely with the program,” said Laura Summers, senior health care analyst at the Gardner Policy Institute and author of the brief. “The research culls essential and helpful information that will help Utahns understand and make informed decisions about Medicaid expansion.”

The brief includes information on program elements, federal and state costs, lessons learned from other states, and policy considerations associated with each scenario.

Here is a summary of each scenario:

  1. Medicaid Waiver Expansion

In 2018, the Utah State Legislature passed H.B. 472. This program expands Medicaid to 70,000‒90,000 adults with income up to 100 percent of the federal poverty level (FPL). This equates to an annual income up to $12,140 ($25,100 for a family of four). The state will impose a tax on hospitals to pay for the expanded coverage.

Utah recently submitted a waiver application to the federal government requesting approval for this program because it differs from what is allowed under federal Medicaid rules. Utah is asking the federal government to pay an enhanced portio