- Associated Press - Thursday, May 22, 2014

SALT LAKE CITY (AP) - Utah may work out a Medicaid-expansion deal with the federal government sometime this summer, state health department director David Patton said Thursday.

Patton told lawmakers on the legislative Health Reform Task Force that Utah officials have been talking weekly with the federal government as they try to work out how to help thousands of the state’s working poor get health care coverage.

“We’ve made significant progress there,” said Patton, who would not offer many details because talks are ongoing.

Under President Barack Obama’s health care law, the federal government has offered to pick up most of the cost if states expand their Medicaid programs.

Gov. Gary Herbert, a Republican, has proposed an alternative expansion plan that would let people purchase private insurance rather than enroll them in the government program. Herbert’s plan seeks a chunk of federal money for a three-year pilot program to cover about 110,000 low-income people.

It’s unclear exactly how much flexibility the governor is seeking, but Patton on Thursday told lawmakers that the federal government seems open to some of the items on Herbert’s wish list, such as enrolling people in private plans and allowing the state to opt out if the terms of the agreement change.

Both of those items are intended to address the concerns of Republican legislators that the federal government may not follow through in the long run on the offer to help pay for expanding the program.

“Sure, let’s shoot for the moon,” said Rep. Jacob Anderegg, a Lehi Republican, who added that he doesn’t think the federal government would be willing to give Utah the money with no strings attached. “I am very interested to see what the governor can work out, but I don’t think we’re dealing with a good-faith partner with the federal government.”

Patton told The Associated Press the federal government seems to be flexible on two major sticking points - that participants are employed and help pay for their coverage - proposals that have generally not been allowed.

Federal officials seem open to a plan that encourages people to work rather than requires it and asks them to help pay for their insurance without denying coverage if they can’t pay, he said.

“If they absolutely say no work incentives, we think that’s unreasonable,” Patton said. “It might be something that we would walk away on. There are some things that we really believe are Utah values that we need to meet.”

The federal Centers for Medicare and Medicaid Services has declined to comment on pending discussions with Utah.

There is no deadline to approve a plan, but Democrats and other advocates for expansion note Utah is losing out on millions in federal money.

Any agreement Utah strikes with federal officials must also get approval from Utah’s Republican-controlled Legislature, which is generally opposed to the health care law and expanding the government program.

House and Senate leaders on Wednesday re-iterated that stance, and they said legislators do not seem to support tackling the issue in a special session this year.

Speaking at his monthly televise news conference on Thursday, Herbert said he remains confident he’ll eventually get lawmakers to buy in on his plan.

“I understand their concerns, I think we can alleviate those concerns,” Herbert said. “And we need to do this as promptly as possible.”

Herbert said he is traveling to Washington in June to continue talks in person with the U.S. Department of Health and Human Services.

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