Senator Daniel Hemmert proposes the following substitute bill:


1     
HEALTH CARE FREEDOM CONCURRENT RESOLUTION

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Daniel Hemmert

5     
House Sponsor: Michael S. Kennedy

6     

7     LONG TITLE
8     General Description:
9           This concurrent resolution encourages the federal government to give states greater
10     control over Medicaid policies by providing Medicaid funding in the form of a federal
11     block grant.
12     Highlighted Provisions:
13          This resolution:
14          ▸     asserts that Utah is best suited to make decisions regarding Medicaid policy for the
15     residents of this state, including prioritizing state Medicaid spending to reflect the
16     unique needs of Utah and setting eligibility standards that reflect state priorities; and
17          ▸     calls upon the federal government to provide Medicaid funding through a federal
18     block grant that would give states greater flexibility to manage the state Medicaid
19     budget and tailor the program to meet state objectives.
20     Special Clauses:
21          None
22     

23     Be it resolved by the Legislature of the state of Utah, the Governor concurring therein:
24          WHEREAS, the American governing principles of self government and federalism
25     require that states, municipalities, and the private sector be empowered to pursue

26     community-driven solutions that reflect the will of the people;
27          WHEREAS, the pursuit of community-driven solutions has proven to be the most
28     effective way to create the elevated dialogue needed to find practical, sustainable solutions to
29     pressing issues that involve strong political disagreement;
30          WHEREAS, the federal Medicaid program started in 1965 and in 2016, provided
31     assistance to an average of over 310,000 Utah residents each month, of which 63% were
32     children;
33          WHEREAS, the federal government is not situated well geographically, politically, or
34     culturally to understand the specific health care needs of Utah families, individuals, and
35     businesses;
36          WHEREAS, in 2016, total Medicaid spending in the United States exceeded $530
37     billion and in the state of Utah exceeded $2.5 billion;
38          WHEREAS, the share of federal Medicaid funding provided to the states is determined
39     by a state-by-state matching percentage, and the actual amount of federal funds sent to the
40     states is determined by how much states spend in order to get those matching dollars;
41          WHEREAS, Medicaid policy is heavily controlled by the federal government, requiring
42     states to apply for waivers if they want the flexibility to reform Medicaid programs to better
43     meet state needs;
44          WHEREAS, states are encouraged to expand Medicaid programs and spend more to get
45     additional federal funds;
46          WHEREAS, the United States Government Accountability Office projects that
47     Medicaid spending will grow by 224% between 2007 and 2032, and at the same time,
48     Medicare and Social Security will put significant pressure on the federal budget;
49          WHEREAS, these cost trends and projections for Medicaid, Medicare, and Social
50     Security are unsustainable and will likely lead to difficult cost shifting in the Medicaid program
51     from the federal government to the states, which will result in states struggling to support their
52     individual Medicaid programs without meaningful control over the policy;
53          WHEREAS, current Medicaid funding arrangements fail to reward states based on
54     performance, but give states additional funding based on outright government appropriations;
55          WHEREAS, Medicaid growth is fueled by an interest in gaining additional federal
56     funding, which also makes reductions in state Medicaid spending more difficult due to the

57     accompanying loss of federal funding;
58          WHEREAS, welfare reform changed the way states managed welfare programs by
59     giving states performance expectations, more policy control, and a set amount of money each
60     year;
61          WHEREAS, because welfare reform has proven to be a success since its passage more
62     than 20 years ago, states should ask for a similar arrangement with Medicaid that would give
63     states more policy flexibility, a set state funding amount, and broad performance goals; and
64          WHEREAS, federal funding for the Children's Health Insurance Program (CHIP) is
65     allocated to states based on a matching rate up to a total set amount of federal funding
66     determined by state need, providing clear precedent for giving states greater latitude in setting
67     eligibility standards and a set amount of funding for similar programs:
68          NOW, THEREFORE, BE IT RESOLVED that the Legislature of the state of Utah, the
69     Governor concurring therein, maintains that Utah is best suited to make decisions regarding
70     Medicaid policy for the residents of this state, including prioritizing state Medicaid spending to
71     reflect the unique needs of Utah and setting eligibility standards that reflect state priorities.
72          BE IT FURTHER RESOLVED that the Legislature and the Governor call upon the
73     federal government to provide Medicaid funding through a federal block grant, including a per
74     capita allocation, and work with states to redesign the Medicaid program to give states greater
75     flexibility to manage the state Medicaid budget and tailor the program to meet state objectives.
76          BE IT FURTHER RESOLVED that copies of this resolution be sent to Utah's
77     congressional delegation, the President of the United States, the Speaker of the United States
78     House of Representatives, the Majority Leader of the United States Senate, and the Secretary of
79     the United States Department of Health and Human Services.