SALT LAKE CITY — Utah legislators are trying to work out an agreement on Medicaid expansion as their 2014 legislative session draws to a close at the end of the week.
The state Senate voted 19-6 on Monday to endorse a proposal that uses federal dollars to partially expand the state-federal health care program for poor people.
The plan advances to the House, where GOP leaders are opposed to accepting federal money.
House Majority Leader Rep. Brad Dee, R-Ogden, said Monday afternoon that the House GOP caucus has not reached a position on the bill. So far, no member of the House has come forward to carry the measure in that chamber.
The plan from Sen. Brian Shiozawa, R-Salt Lake City, would help about 60,000 people living below the federal poverty level to buy private health coverage.
Because of a gap in President Barack Obama's health care law, those people are not covered by Medicaid or eligible for federal subsidies to pay for private insurance.
If federal officials do not approve the plan, Shiozowa's proposal allows Gov. Gary Herbert to continue negotiating with Washington, D.C., to pursue his plan for a block grant.
"That would also give Utah a unique ability to take that money and apply it best for that group of people who most need it," Shiozawa said.
Utah's Republican-controlled Legislature and the GOP governor are no fans of the health care law.
"We have no options that I consider good in this arena," Sen. Daniel Thatcher, R-West Valley City, said when voting for Shiozawa's bill. "I think this is the best of the bad options before us."
Under the law, the federal government has offered to pick up the full cost through 2016 for states expanding Medicaid to include people earning up to 138 percent of the poverty level. After that, reimbursement levels will gradually fall to 90 percent by 2020.
Herbert, who recently announced his plan for the program after months of delays, doesn't want to enroll more of Utah's poor to the Medicaid program.
Instead, he's seeking a chunk of federal money to help about 110,000 people enroll in private health coverage as part of a three-year pilot program. Participants would have to chip in with some costs.
Utah's Department of Health estimates the program would use $250 million in federal money the first year, and grow to about $280 million in the third year.
It's similar to plans approved in other Republican states such as Arkansas, which have resisted growing the government program. But Herbert's plan appears to seek unprecedented flexibility, and it's unclear if federal officials would approve it.
Democrats unsuccessfully tried to change Shiozowa's plan to embrace a full expansion of the program as offered under Obama's law.
"With full expansion, we get everyone covered in the state of Utah," said Sen. Gene Davis, R-Salt Lake City. "It provides full health care. No games."