美国国家公共电台 NPR Utah Voters Approved Medicaid Expansion, But State Lawmakers Are Balking

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DAVID GREENE, HOST:

Utah residents may have thought they were done fighting about health care back in November. That's when voters approved a ballot¹ measure to expand Medicaid to more uninsured adults, but now Utah lawmakers want to roll that back. KUER reporter Erik Neumann has been tracking this renewed debate inside the Capitol and also outside on the snowy streets of Salt Lake City.

ERIK NEUMANN, BYLINE²: Health care advocates are so mad they've hired a billboard³ truck to drive around the city urging voters to call their lawmakers. I jumped into the truck to chat with driver Gregory Shalfont as he was doing laps around the Capitol building.

It's funny. It's kind of an old-school approach to getting the message out there. We're literally⁴ just in, like, a big U-Haul with an electronic billboard on the outside circling it (laughter).

GREGORY SHALFONT: It is, and it's really effective. It shows up real well day or night, and we have sound attached to it.

NEUMANN: Shalfont was working for Utah Decides, the group that helped pass Proposition 3 last November. Utah voters hoped that after six years of talking about Medicaid expansion, it was finally done. They approved it by 53 percent. But when the legislative⁵ session began last week, the issue erupted again. Republicans dominate in Utah, and they want to scale back the Medicaid expansion. Some say repeal⁶ it.

ANDREW ROBERTS: We voted for this on November 6. We were very clear about what we wanted, and I think...

NEUMANN: That's Andrew Roberts with Utah Decides inside the Capitol. His group says with full Medicaid expansion, 150,000 uninsured residents could finally get coverage⁷.

ROBERTS: We are frustrated⁸, and I think Utahns are frustrated.

NEUMANN: The same thing is happening in Idaho. Voters passed Medicaid expansion last November, and now their lawmakers are also trying to roll it back. State Senator Allen Christensen, a Republican, is leading the rollback effort in Utah. He says his bill would still expand Medicaid but would cap the number of patients who would qualify. He claims that what the voters originally passed in November would bust⁹ the state's budget.

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ALLEN CHRISTENSEN: They wanted Medicaid expansion, and that's what we're doing. They didn't fill in the proper blanks. We are filling in those blanks for them. They are not obligated to balance the budget. We are.

NEUMANN: Christensen's bill says instead of making around $16,000 per year to qualify, you could make at most 12,000. And it would add work requirements.

MATT SLONAKER: From the perspective of voters, I think voters have a right to be furious right now.

NEUMANN: That's Matt Slonaker. He leads the Utah Health Policy Project, a group that supported expansion. He says changing Proposition 3 would mean fewer people get health coverage, and the state would get less money from the federal government. Not only that, it could make voters disillusioned¹⁰.

SLONAKER: Why would voters ever want to pursue ballot initiatives and direct democracy if the legislature's just going to repeal it anyway?

NEUMANN: No one claims that Medicaid doesn't cost money. That's why the Utah ballot question included a new sales tax increase to pay for it. And supporters point to the fiscal¹¹ experience of other states. Economist¹² Bryce Ward¹³ studied what happened after Montana expanded Medicaid in 2016. Ward says the Medicaid expansion brought in about $600 million in new funds for Montana each year, and that money rippled¹⁴ through the state supporting about 6,000 additional jobs.

BRYCE WARD: You should think of Medicaid expansion as no different than if you had said, oh, hey, somebody's going to open up a factory - right? - and that factory is going to bring, you know, in the case of Montana, $600 million of outside money into the state that we're going to pay to workers here.

NEUMANN: So far, Utah lawmakers remain unconvinced by studies like Ward's. The bill to restrict Medicaid is moving fast and could reach the governor's desk as soon as next week. For NPR News, I'm Erik Neumann in Salt Lake City.

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