At a Legislative preview event held by the United Way, House Speaker Rebecca Lockhart, R-Provo, discussed the possibility of funding an expansion of Medicaid. Lockhart agreed there was need to cover uninsured Utahns, but also made it clear Uncle Fed was not a partner to be trusted in the deal, when it comes to the expectation that federal aid would fund 90 percent of the expansion in three years.---

At the event Lockhart and other lawmakers spoke of the possibility that a Medicaid expansion could fill the “donut hole” of coverage existing within the Affordable Care Act for uninsured Utahns who don’t currently qualify for Medicaid. This sweet comparison is anything but for the more than 50,000 uninsured Utahns under the 100 percent federal poverty line, left out of coverage if the state doesn't expand Medicaid.

If Utah were to join 25 other states in expanding Medicaid, 100 percent of funding for three years would be paid by the federal government, after the third year Utah would chip in 10 percent of the cost.

For Lockhart, the only problem is that while the federal government has a knack for printing money and making promises it doesn't hold a great track record for paying debts and backing up its agreements. Lockhart did not negate the “human issues” tied up in the debate.

“They are all real, they are legitimate,” Lockhart said. “But as a policymaker what we have to think about is not only those things but the revenue it will take to address this issue not just now but in the future.”

Lockhart rattled off some recent examples of the federal government's slacking on funding from cuts in transportation funding for interstate transportation, mineral lease revenue and “Payment In Lieu of Taxes” or PILT, a matter that's been cause of major panic for Utah counties. PILT refers to money the federal government pays to counties for federal lands in their boundaries, since they cant receive taxes from the land. With PILT money left out of the recent congressional budget Utah counties are expected to take a $35 million hit to their budgets.

“I was just in Kane County the other day and those commissioners tell me if they don't get their PILT payment, that's 30 percent of their their budget,” Lockhart said. “This is what the federal government does, this is what the federal government will continue to do when they are in dire straits.”

That being said Lockhart did tell the crowd that if Utah did expand Medicaid it would be under the assumption that they would be “fools” to expect to only pay 10 percent of the share after the first three years of the program and therefore would need to start saving additional program funding, starting this year. The issue is expected to be a hot topic of conversation when the 2014 Legislature begins at the end of this month.

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