Q&A: Matt Slonaker discusses Medicaid redetermination concerns and how COVID will change Utah


Patrick Jones


Q&A: Matt Slonaker discusses Medicaid redetermination concerns and how COVID will change Utah. Matt Slonaker is the executive director of Utah Health Policy Project (UHPP). He has been with UHPP for around ten years, aiming to bring every Utahn health insurance coverage and lower the uninsured rate. 

Slonaker will be speaking on the topic of how COVID has changed Utah’s health system at our 2022 Utah State of Reform Health Policy Conference on April 7th in Salt Lake City. 

In this Q&A, Slonaker discusses how he is preparing for Medicaid redeterminations at the end of the public health emergency (PHE) and how COVID has changed Utah’s health system. 


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State of Reform: What are you spending your mental energy on these days? What’s the biggest thing happening in Utah healthcare right now? 

Matt Slonaker: “We’re in the throes of the final week of session. I am hoping to get priorities passed that could really improve the lives of a lot of Utahns. We came out of a very successful open enrollment year for the Affordable Care Act. Utah’s uptake in the Affordable Care Act went from around 207,000 enrollees to closer to 257,000, which is the largest increase since the first year. Those are folks that, in large part, have gone without great insurance, and I think some of the federal policy changes have made it more affordable for individuals. We ourselves at Utah Health Policy Project have an outreach and enrollment program, and we’re one of the few non-profit broker organizations in the nation. It was just a successful year from the standpoint of getting folks covered. 

We are in a pandemic, so that’s presented its challenges. Much of our success may be due to the nature of what has happened with the pandemic, but it’s also hindered us [from] having as many face to face opportunities with the folks that we serve. We still grew by 50,000, and I don’t know how to make sense of that, but that’s what happened. 

The public health emergency is potentially going to end in July. I don’t think we have our ducks in a row to appropriately address the cliff that eliminating the public health emergency will cause in the Medicaid program. We’ll see a number of folks who will be up for redetermination, and within 60 or 90 days, we could lose as many as 50,000-100,000 folks dropping off of Medicaid.”

SOR: How is UHPP working to prepare for the end of the PHE?

MS: “With the public health emergency, we aren’t ready because the only way to solve this problem is educating the public over time and slowing down the off ramp. We will only have about 60-90 days. What can you do in that time period? Make thousands of calls, try to send thousands of letters? You’ve got to be culturally and educationally competent for the folks who are receiving those calls and letters, many people’s addresses have changed or phone numbers have changed, and the pandemic has upended many people’s lives. 

We’re advocating for a longer off ramp that staggers the approach to the redeterminations. That way, we keep as many people in the program without redetermination as we can for the longest amount of time possible. Because in the end, it doesn’t behoove us to drop anyone from Medicaid coverage. It comes down to providing more time, robust communications, a lot of partnership across stakeholders with government, to make sure everyone is fully knowledgeable about this need to be re-determined or to find another health care option. 

I do think the state can do things. We should take every opportunity to keep people in the program. It would be foolish to think this is a time to be okay with having people fall off of the Medicaid program. I think there are some folks out there that might think that’s a fiscally responsible thing, but that’s just not how it works. In reality, people are busy and they think they’re covered. So, if they’ve moved, changed their phone number, and they haven’t heard about this need to re-determine, it’s not fair to them to suddenly surprise them with the fact that you don’t have coverage anymore.”

SOR: What are some of UHPP’s legislative priorities as the session comes to a close in the next couple days?

MS: “As for our priorities, we’ve been working on a bill to support young, low income mothers who would be potentially eligible for Medicaid, if we offered it to a bit higher income levels. We have hit some roadblocks there. We’re still hopeful, but may not be something that gets through this year. We’re also hoping that there’s an option to cover all kids in Utah. There’s been some positive energy on this. It passed the Senate committee and went into the Senate, so we’re hoping to move it through the House quickly in this final week. Kids in Utah are much too often uninsured.”

SOR: How has COVID changed the way we give care in the state?

MS: “I think it’s going to forever change how health care is delivered in Utah and across the nation, probably across the world. I think our public health response and how it was affected by politics is going to play a role into the future. I think there’s a lot of people that want to get back to normal or pre-pandemic, but I don’t think we can. I think it’s the cats out of the bag and everything has shifted. So, what we need to do going forward is acknowledge and understand that there are going to be long term results from the pandemic on Utah’s health system and health care systems across the country and world. This is especially true from the standpoint of long haul dollars for one, since we will have a new class of people that are forever impacted by this disease. 

I don’t know if anyone knows all the answers, but I think what struck me is the interest in moving forward and not wanting to look back, learn and take those lessons and implement what you’ve learned in a prudent way through policy. I think we’re just moving forward past this pandemic, and not necessarily learning from it.”

This interview was edited for clarity and length.