5 Things Utah: Sen. Gene Davis, Medicaid expansion, New ambulatory care clinic

In this time of national economic expansion, it feels like we should be making more progress on the big issues we face together as Americans.  With yield curves inverting, a recession feels like it looms ahead, cutting our collective margin for error.

However, in my rare moments of cynicism, I’m reminded of the old African proverb “If you want to go fast, go alone. If you want to go far, go together.”  Whatever our pathway forward on health reform, it’s probably better to go together, even if that takes us longer than we’d like.

With help from Emily Viles


1. White House makes a mess of Medicaid

In a letter released Friday, CMS formally let the Utah Department of Health know that: “we will not authorize the enhanced match rate if enrollment caps are implemented through section 1115 demonstrations for the new adult group.” CMS had previously let the state know it supported Utah’s waiver application, only to find out days ahead of its submission that the White House had taken a different view. The White House’s verdict was made clear with last week’s letter.

The letter does not address other elements of Utah’s ask for 1115 waiver authority, including the adult dental provisions or the at-risk youth amendment. CMS will take public comment on Utah’s application through September 15th.


2. U of U Medical Campus transformation update

The new University of Utah medical center transformation is well on its way. The 296,000 square-foot center will host three state-of-the-art buildings: an ambulatory care complex, a rehabilitation hospital, and a medical education and discovery center. The 131.5 million dollar ambulatory care center is expected to be open soon and will host 123 treatment rooms, 72 new inpatient beds, 7 flexible outpatient clinic modules, and 6 new surgical suites as well.

The medical center is expected to increase patient capacity, expand access to care, and provide more appropriate care through outpatient services. According to the University, the goal is “to reshape and modernize our campus in a way that will dramatically enhance our capacity to advance our educational, research and clinical missions.”

3. Mental illness spikes, access to care decreases

A new report conducted by the Kem C. Gardner Policy Institute and the Utah Hospital Association shows that while more than one third of Utahns suffer with mental illness, less than half seek mental health care. The number of Utahns with mental illness has also risen considerably over the last 5 years.

The report explains that the bifurcated system of funding, and the generally low levels of funding, makes care coordination between physical and mental health difficult. The report also cites commercial health insurance coverage of mental health as limited in the state, which can lead to higher out-of-pocket costs, deterring consumers from seeking care.

4. Video: Senator Gene Davis, Health Reform Task Force

Senator Gene Davis is a member of the Health Reform Task Force. He is also one of the most senior members of the Utah legislature, having first been elected in 1986. He joins us in this edition of “What They’re Watching” to discuss affordability and access.

“We need to make sure that we have a good, firm, and stable health care system. And, really, everybody says that it is broken, everybody wants patients to change instead of wanting the system to change. The Affordable Care Act really gave us the opportunity to make some of those changes.”

5. “Don Quixote” goes to Washington DC

National Democratic figures are laying the ground work for health reform policy in a new administration, hoping that the 2020 election will swing their way. One of the quieter but perhaps more influential players in this discussion is former Oregon Governor John Kitzhaber.  You’ll recall he was our keynote speaker at our conference earlier this year. Kitzhaber has been quietly convening key federal policy advocates, both in public and privately.

I spent a few days with Gov. Kitzhaber on a recent trip to DC as he was trying to focus the opinion of DC insiders away from a solution, and towards a better understanding of the problem. “Medicare for All is really a financing mechanism. And, if we don’t reform the underlying delivery system, the way we finance it won’t get at the root problems of quality in health care.”