Utah receives approval for Medicaid expansion with work requirements

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ST. GEORGE — The Utah Legislature approved full Medicaid expansion that will offer coverage for the state’s poorest residents.

In an announcement Monday, a representative from the Utah Department of Health stated the organization would expand Medicaid to cover residents making up to 138% of the federal poverty level, which is $16,753 a year in salary for an individual or $34,638 for a family of four.

The additional expenses associated with the expansion are being subsidized by the state and federal government, with the federal government covering 90% of the costs and the state covering the remaining 10%.

The expansion is expected to include more than 40,000 additional people — to make for a total of 120,000 people covered — starting Jan. 1.

Southern Utah

Jenny Johnson, Utah Department of Health public information officer, told St. George News that the Medicaid expansion isn’t likely to affect the large retirement population in Southern Utah as when individuals reach the age of retirement, they instead apply for Medicare.

“With the Medicaid expansion, now there’s going to be a lot more individuals eligible to apply for Medicaid and a good majority of those could potentially be in rural areas where the income level is not as high,” she said.

Johnson said the department is encouraging residents who are in need of health insurance to apply, even if they have applied in the past and were unqualified, because the expansion might grant them coverage.

Work requirements

The latest draft of Medicaid expansion included a new work requirement, however, that could cause 7,500 people to lose coverage. The mandate requires people to obtain coverage through their employer if it is provided, but Medicaid will help with their premium.

The federal government has generally supported work requirements in previous Medicaid expansion efforts in other states, allowing South Carolina to impose them earlier this month. Nearly 20 states have asked to implement them, but a number have been denied or backed out amid court challenges.

In Arkansas and Kentucky, a federal judge denied the requirements, arguing that the mandate would impede the program’s ability to provide health care for low-income residents. In states such as Arizona, Indiana and New Hampshire, work requirements have also been suspended or dropped.

Legislators argue the work requirement is different from previous renditions because it’s based on efforts to look for work rather than the number of hours an individual is reported to work. It also includes exceptions for those who are 60 or older, pregnant or caring for young children.

Although roughly 80% of people who qualify for Medicaid won’t be held to the work requirements, those who do will need to complete an online job assessment, web-based training programs and 48 job searches within the first three months of being eligible for Medicaid.

The federal government has yet to weigh in on additional requests made by Utah officials, including premiums and surcharges for people over 100% of the federal poverty level and penalties for intentional program violations.

Medicaid expansion was passed by a public vote last year in Proposition 3. Legislators argued that the Medicaid expansion was too expensive and blocked Medicaid’s full implementation with SB 96, which overrode Proposition 3.

Gov. Gary Herbert speaks in St. George, Utah, June 13, 2018 | File photo by Mori Kessler, St. George News

Gov. Gary Herbert’s office issued a statement Monday defending the inclusion of the work requirement in the expansion.

“This is a relatively short period of time because we have many resources available that actively engage in helping people in these programs prepare for and find better jobs,” the statement said. “We believe this is the best way to help people out of poverty, and that by creating pathways that pave the way to a better future, we do more than simply provide for immediate needs.”

The requirement, the office argues, is flexible and charitable. There are a also number of exceptions that allow residents who are physically or mentally unable to work to still participate in the program. Due to this, the statement reads, the newly approved program will help “vulnerable Utahns rise out of difficult situations.”

Residents can obtain more information about the application process, work requirement exceptions and more on the Utah Department of Health’s website.

Copyright St. George News, SaintGeorgeUtah.com LLC, 2019, all rights reserved.

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