Utah hospitals to state: Don't expand Medicaid

State hospital association favors a 'free-market solution' for low-income residents

The Utah Hospital Association (UHA) has urged the state not to participate in the Medicaid expansion, an unexpected move as hospitals nationwide ramp up campaigns to fight for the Affordable Care Act (ACA) provision.

When the Supreme Court upheld the ACA in June, the justices ruled that states can opt out of the expansion without any effect on current funding, essentially leaving the final decision up to each state's governor. So far, Republican governors in six states—Florida, Georgia, Louisiana, Mississippi, South Carolina, and Texas—have announced that they will not participate.

Where does your state stand on the Medicaid expansion? Click to expand either a quick-to-scan graphic or an interactive graphic. (Note: interactive graphic may not be optimized for mobile devices.)

For hospitals, the Medicaid expansion is expected to reduce uncompensated care costs. As such, the American Hospital Association has expressed its support for the expansion, and state hospital associations have launched local campaigns to convince state leaders to opt into it.

However, UHA in a position statement sent to health industry leaders last month said, "there are too many practical and political decisions to be made… to support the full Medicaid expansion at this time." Among the association's chief concerns is the "adverse impacts on the commercial insurance market."

According to UHA President Rob Betit, the state's hospitals are not entirely opposed to expansion. "We're in favor of a more thoughtful, graduate approach," he says, adding, "We support finding a Utah solution that works for our state, focusing on a free-market solution."

About 58,000 additional Utah residents would qualify for Medicaid under the expansion. Betit says the state might consider steering those individuals into private health plans made affordable with federal tax credits. 

As of Wednesday, Utah Gov. Gary Herbert (R) had not yet indicated whether he planned to participate in the Medicaid expansion (Stewart, Salt Lake Tribune, 11/8).

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