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From ballot initiative to waivers: what is the status of Medicaid expansion in Utah?
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
Guth, Madeline, author
Rudowitz, Robin, author
Hall, Cornelia, author - Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- San Francisco, CA : Henry J. Kaiser Family Foundation, November 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage
Medicaid -- legislation & jurisprudence
Eligibility Determination
Utah
United States
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. 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. (1) Bridge Plan. 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. (2) Per Capita Cap. On July 31, 2019, Utah submitted to the Centers for Medicare and Medicaid Services (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 to 100% FPL 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.1 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. (3) Fallback Plan. The state legislation requires the submission of a "Fallback Plan" waiver should CMS not approve the Per Capita Cap waiver. On November 4, 2019, Utah submitted to CMS its Fallback Plan waiver that would expand Medicaid to 138% FPL and would continue some other provisions in the earlier waivers, including an enrollment cap. In its submission letter, Utah says that CMS rejected its PCC waiver request, although the waiver is still listed as pending on CMS' website as of November 14, 2019. (4) Ballot Approved Expansion. If CMS does not approve the Fallback Plan by July 1, 2020, Utah must adopt the full Medicaid expansion without restrictions as required by the ballot initiative.
- 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 (11 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101767730 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101767730