From ballot initiative to waivers: what is the status of Medicaid expansion in Utah?
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Musumeci, MaryBeth, author Rudowitz, Robin, author Hall, Cornelia, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- [San Francisco, California] : Henry J. Kaiser Family Foundation, September 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Care Reform Insurance Coverage Medicaid Eligibility Determination Income Pilot Projects Poverty Humans United States Utah United States.
- Genre(s):
- Technical Report
- Abstract:
- Since Utah voters approved a November 2018 ballot measure to adopt the Affordable Care Act (ACA) Medicaid expansion up to 138% of the federal poverty level (FPL), the state legislature has taken steps to roll back the full expansion. The state enacted a law in February 2019 that amended the voter-approved ballot measure, requiring the state to submit a series of Section 1115 waiver requests limiting the expansion to 100% FPL, first at its regular matching rate and then requesting the enhanced federal matching rate of 90%. The first waiver, the "Bridge Plan," was approved in March 2019, and allowed the state to implement a coverage expansion to 100% FPL beginning April 1, 2019, at the state's regular matching rate. The approved waiver also included an enrollment cap and a work requirement. On July 31, 2019, Utah submitted to CMS its "Per Capita Cap" proposal for a new waiver that would continue a number of provisions already approved as well as a request for the enhanced match for partial expansion and a limit on enhanced federal funding. CMS issued a general statement in late July and a letter to the state in mid-August confirming that they would not approve the enhanced matching rate for an expansion that does not go to 138% FPL or that includes an enrollment cap. Given CMS guidance about partial expansion, it seems clear that some provisions of the Per Capita Cap waiver will not be approved, but CMS says it is reviewing the other provisions. If CMS does not approve Utah's July 2019 waiver submission, the state is required to submit a subsequent waiver, the "Fallback Option," that would seek the enhanced match for coverage to 138% FPL and continue some other provisions in the earlier waivers, including an enrollment cap. If CMS does not approve the Fallback Option by July 1, 2020, Utah must adopt the full Medicaid expansion without restrictions as required by the ballot initiative. This brief provides additional detail about the ballot measure, the state legislation, the status of the required waiver submissions, and the broader implications of Utah's waivers for other states.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101754986 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101754986