The Trump administration has approved Utah’s limited Medicaid expansion plan, allowing the state to offer Medicaid only to people earning up to the federal poverty line.
The partial Medicaid expansion will provide coverage for up to 90,000 people. But the plan, which was approved by the Centers for Medicare and Medicaid Services (CMS), will cover far fewer people and cost more money than what voters approved in November.
In an unprecedented move, the plan will also allow Utah to cap enrollment in the program if state spending exceeds budget expectations.
{mosads}Utah’s plan also includes a work requirement and a requirement for eligible individuals to enroll in their employer-sponsored insurance plans, if available. However, these two policies will not be implemented until January 2020.
The approval comes just days after similar work requirements in Arkansas and Kentucky were struck down by a federal court, in part because of the number of people who would lose coverage.
More than 18,000 people have lost Medicaid coverage in Arkansas since the program became the first to take effect last summer. And 95,000 were estimated to lose coverage under the Kentucky program, which hadn’t yet gone into effect.
The Utah program is expected to only be a temporary “bridge” for the next year. In the coming months, the state is expected to submit a request to the Trump administration to pay 90 percent of the cost of expansion — a request that has never been approved previously.
In exchange, Utah will ask for permission to impose per-capita spending caps and other cost control measures on beneficiaries.
“This is an important first step in covering vulnerable Utahns in a financially sustainable way,” Gov. Gary Herbert (R) said in a statement. “But it’s just a first step. In the coming months, we will submit a detailed proposal seeking a new funding arrangement with CMS that will decrease the state’s share of the costs, provide the federal government with assurances on its costs, and provide the state with additional flexibility to manage the program.”
Under the newly approved plan, Utah residents who earn up to 100 percent of the federal poverty level, about $12,492 for an individual or $25,752 for a family of four, will be eligible to receive full Medicaid benefits.
In November, Utah residents voted for a complete Medicaid expansion under ObamaCare to people earning up to 138 percent of the federal poverty level. However, Herbert and state Republican lawmakers instead passed a law calling for the partial expansion plan.
Anyone earning between 100 and 138 percent of the federal poverty level will have to purchase coverage on the federal exchange.
The voter-approved plan would have covered 150,000 people, and would have been paid for by an increase in the sales tax.
The new plan will cover about 48,000 fewer people, and will cost $50 million more than full expansion, according to a state analysis.