The 2014 Utah State Legislative Session has finally kicked into high gear. We have 10 days left to finalize the budget and consider three competing proposals to provide health coverage to uninsured Utahns.
Revised budget projections were finally released Friday afternoon. While the numbers are better than anticipated in October, the $253 million in new money is far less than the $800 million appropriations committees requested for ongoing programs. Additionally, almost $214 million of earmarked for public and higher education. That leaves about $40 million for everything else, including Medicaid caseload growth, DSPD, mental health, vocational rehabilitation caseload growth, and low-incidence/high-cost special education services, among others.
The Executive Appropriations Committee has to make its final budget recommendations by Friday. Because there is so little money available, if an item is going to be funded it needs to be ranked as highly as possible. This weekend is the time to contact legislative leadership and ask them to do just that with items of importance to you, your family, or your friends. For your reference, here is our list of some of the disability-related items prioritized by the appropriations committees.
The other big news of the week is that all three healthcare coverage proposals are now on the table. As noted last week, the House leadership's plan would use $35 million in state money to expand premium assistance or provide basic primary care for some of the 60,000 uninsured low-income Utahns. On the other hand, Governor Herbert's proposal would allow Utahns up to 138% of the federal poverty level (FPL) to use Medicaid dollars to help purchase a commercial insurance product. The amount of the subsidy would vary depending on an individual's health care needs, ability to work, access to other insurance, and family circumstances. In the middle is Senator Shiozawa's proposal to use federal dollars to subsidize the purchase of private coverage by individuals up to 100% of the FPL. Medically frail individuals would continue to be eligible for traditional Medicaid. Finally, the proposal requires the state to seek significant flexibility in designing plans and benefits. To learn more, see the Utah Health Policy Project's side-by-side comparison of all three proposals.
Each of the proposals comes with unique challenges. The House leadership plan likely won't cover all Utahns who fall in the coverage gap. In total, the proposal appears to cost about the same as expanding Medicaid, without necessarily providing greater access to more affordable or better quality care. While Senator Shiozawa's proposal would cover about twice as many Utahns as projected under the House leadership's proposal, it is unclear whether the federal government will allow the state to expand to only 100% of the FPL, or grant any of the other waivers envisioned by the proposal. Unfortunately, there doesn't seem to be much appetite among legislators to expand all the way to 138% of the FPL, as the governor has proposed.
This week we will try to have conversations with as many legislators as we can to find out what they think of the proposals. If they are supportive, which arguments worked? If they are undecided, what would help them make up their mind? If you have a similar conversation with your senator or representative, please let me or others you work with know what you learned.
Tuesday looks like it is the last day for a bill to be heard in committee. Given that, Monday is going to be busy:
- Sen. Valentine's SB 49 would make it nearly impossible for schools to assess or evaluate students for special education placement or services, in our opinion. It will be heard by Senate Education in Room 210 of the Senate Office Building at 8 AM.
- Sen. Osmond's SB 110 originally proposed to allow a parent or family member of an incapacitated adult to ask the court to reduce or reimburse the fees associated with obtaining guardianship of their family member with a disability. We asked Senator Osmond to consider allowing a person with a disability, who wishes to contest a guardianship order, but cannot afford to do so, the same opportunity. However, it now appears that, if a proposed substitute is adopted, the bill will focus on expanding access to the online court assistance program. The bill is scheduled to be heard on Monday at 8 AM in Room 250 of the Capitol by Senate Health and Human Services.
- Sen. Bramble's SB 245 expands access to an online voting pilot project to Utahns with disabilities who live in counties which choose to participate. The bill will be before the Senate Government Operations Committee at 8:30 AM on Tuesday in Room 415 of the Capitol.
To keep up with other bills as they make their way through the process in the final days, see the DLC's updated bill tracker and visit our website regularly.
If there is anything I have missed or if you have any questions or concerns, please do not hesitate to contact me. As always, thank you for your interest and support.
Public Policy Advocate
Disability Law Center