Speaker Wilson reflects on Medicaid expansion fights ahead of 2020 session

Ahead of the first day of Utah’s 2020 legislative session on Monday, Speaker Brad Wilson sat down with Bryan Schott and Bob Bernick of UtahPolicy.com to discuss pressing issues in Utah state policy and politics.

Over the course of a 23 minute podcast recording, Speaker Wilson touched on a variety of topics, including education funding, mental health legislation, the Utah governor’s race, and Medicaid expansion.

On the subject of Medicaid expansion, Schott pressed Wilson on whether the GOP’s efforts to scale back voter-approved Medicaid expansion were worth the fight given where Medicaid expansion in Utah stands today. Schott noted that after the Republican legislature delayed implementation, they ended up in roughly the same place — save for a few additions — as if they would have proceeded with the full expansion Utahns voted for under Proposition 3.


Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.


Wilson maintained that the Legislature’s efforts were worth it, and that Utahns should feel secure about the current state of health care in Utah.

I think the policy is better than what it would have been a few years ago for a number of reasons. We have a significant tax that has to be levied on the citizens to pay for this program, and it looks like that revenue over time is not going to cover the cost of expanding this entitlement, even with the safeguards we’ve put in place. We thought there would be different options, it looked like we cascaded to option two after our waivers were denied in the first round. I think it’s good we have some certainty on this so people can move forward and make decisions about their health care and we can make decisions about the state budget and we’ll move on.”

Schott responded by questioning whether feelings of certainty were warranted, given the recent weakening of the ACA and the looming possibility that it might be deemed unconstitutional.

If that happens, lawmakers are going to be in the position of taking away something from people that they were given, and that’s usually not a very popular thing to do and in order to keep it you might be on the hook for the whole thing,” said Schott.

Schott’s prognostications elicited a sober response from Speaker Wilson: “Yep.”