Pub. 4 2020 Issue 1

W hen I moved to Utah almost six years ago from the San Francisco Bay Area, many people were talking about “Medicaid Expan - sion.” It’s embarrassing to admit now, but I was not familiar with expansion. I was lucky enough to have insurance. California had long ago expand - ed its Medicaid program. What was everyone talking about? I would soon become deeply immersed in Utah’s fight to ex - pand Medicaid when I joined the nonprofit children’s advo - cacy group, Voices for Utah Children. My organization, along with many others, including the Utah Academy of Family Physicians, the Utah Health Policy Project, AARP of Utah, the Association for Utah Community Health, and others, worked together over the years to close the Medicaid coverage gap. Utah’s fight to expand Medicaid has been long and challeng - ing: numerous legislative efforts; a 2018 statewide ballot initiative in which Utahns voted for full expansion; the Legis - lature’s complicated multiphased modification to the voter- approved expansion, which left many Utahns frustrated and confused and still without coverage. Finally, on Jan. 1, 2020, Utah accepted full expansion and became the 37th state in the nation to expand Medicaid and close the coverage gap. As we now face the dual crises of a pandemic and economic downturn, it is more important than ever to look at what Medicaid expansion means for Utahns and the actions we need to take going forward. What was the Medicaid Coverage Gap? A Quick Re- fresher: Since its inception, Medicaid has been a health insurance program for low-income children, seniors and people with disabilities. Medicaid is financed through a shared state-federal financial arrangement. The feds take on most of the cost of the program, with states providing a “match.” In Utah, the federal government pays about 70% of our Medicaid costs, while Utah puts up the other 30%. Over the years, new categories of people have become eligible for Medicaid, such as pregnant women and extremely low- income parents. But until recently, most parents and almost all low-income adults under 65 and without a disability had not qualified for Medicaid coverage. A key piece of the Affordable Care Act was that it directed all states to expand their Medicaid program. Knowing this would be a financial challenge for states, the ACA said that states would pay no more than 10% of the cost to expand Medicaid, and the federal government would cover the remaining 90%. By Jessie Mandle, Senior Health Policy Analyst at Voices for Utah Children Utah Finally Expands Medicaid www.UtahAFP.org | 26