Trump administration likely to deny Utah’s 90/10 Medicaid funding request

The Washington Post reported late on Friday that the Trump Administration is likely to deny funding for Utah’s Medicaid expansion efforts. 

We have been tracking Utah’s 1115 waiver, and the implementation of Medicaid expansion provisions passed during the legislative session, for several months. Before the 2019 session began, Utahns passed Prop 3, which sought to extend Medicaid coverage to Utahns earning up to 138% of the federal poverty level. The proposition also stated that the federal government would cover 90% of funding, while the state made up the last 10%. 

During the session, legislators overrode the implementation of Prop 3, and instead voted to implement a narrower version of Medicaid expansion. New Medicaid expansion in the state covers 100% of those under the poverty level. Importantly, the state submitted a request for approval of the 90/10 funding split despite the compliance with expansion efforts required by the ACA

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Utah’s plan expands Medicaid to individuals earning up to the poverty line, $12,490 a year for an individual and $25,750 for a family of four, and wants the federal government to pay the state the more generous reimbursement reserved for a full expansion under the ACA.

According to the Post, the Trump administration is likely to deny the request for this 90/10 split. This denial of funding absent of increased expansion efforts is not a new trend. The Obama administration also denied requests from states that sought similar funding strategies in an effort to encourage overall Medicaid expansion. 

The reason for Utah’s recent funding rejection, however, is a result of the Trump administrations assertions that the entire ACA is unconstitutional

The Utah Department of Health plans to submit an additional request for funding directly to CMS in the coming weeks. These funding requests are not a result of the denial, but were mandated by the legislature.  

“We’re still preparing to submit our waiver as directed by state legislation passed this year. We have not received any indication, one way or the other, how CMS may act on the waiver once we do submit it,” Tom Hudachko, spokesman for the Utah Department of Health, commented in the Post article

Decisions on the status of the court proceedings regarding the constitutionality of the ACA are likely to come in the next several weeks. There is not an exact date for when the state will file funding requests with CMS, or information on next steps following the funding denial.