Utah Proposition 3, the Medicaid Expansion Initiative, was on the ballot in Utah as an initiated state statute on November 6, 2018. It was approved by a vote of 53 percent to 47 percent. Proposition 3 expanded Medicaid coverage to include persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line according to traditional Medicaid expansion under the Affordable Care Act. It also increased the state’s sales tax rate from 4.70 percent to 4.85 percent, with revenue allocated toward the state’s portion of the cost of Medicaid expansion.
On Monday, the legislature gave final approval to Senate Bill 96 to repeal and replace Proposition 3, and Governor Gary Herbert (R) signed it into law. Changes proposed by the bill include limits on eligibility for Medicaid coverage, such as a work requirement; restrictions on the total number of people who could enroll; and changes to the provisions concerning the sales tax increase, although the sales tax increase would be implemented under SB 96 as it was designed to under Proposition 3. It would require special approval of waivers from the Federal government and contains contingency provisions that take effect if the waivers aren’t approved.
Utah Sen. Allen Christensen (R) introduced Senate Bill 96. The bill passed in the Senate on February 4, 2019. The bill passed with amendments in the House on February 8, 2019. The Senate concurred with the House’s amendments, and the governor signed the bill on February 11, 2019. All six Senate Democrats and all 16 House Democrats voted against the bill. One Republican Senator, Todd Weiler of District 23, and three House Republicans—Craig Hall (33), Eric Hutchings (38) and Steven Eliason (45)—also voted against the bill. The remaining legislative Republicans voted in favor of SB 96.
Utah has a Republican state government trifecta, meaning Republicans control both chambers of the state legislature and the governorship. Utah is one of three Republican trifecta states that approved Medicaid expansion initiatives in November 2018. The other two are Idaho and Nebraska.
Utah is one of 11 states that have no restrictions on legislative alterations, which means the legislature can amend or repeal initiated state statutes with a simple majority vote at any time.
Statement from Governor Gary Herbert:
Governor Herbert said, “SB96 balances Utah’s sense of compassion and frugality. It provides quality coverage to the same population covered by Proposition 3 in a meaningful, humane and sustainable way. It is now time to set aside differences and move forward to get those in greatest need enrolled on Medicaid and on the federal health care exchanges.”
Response from Proposition 3 supporters:
Utah Decides Healthcare, the Proposition 3 support campaign, “This is a dark day for democracy in Utah. State legislators turned their backs on voters and on families in need. This bill leaves billions of our tax dollars in Washington and cuts healthcare for tens-of-thousands of Utahns. While special interests and politicians celebrate the success of their backroom deal, Utah families will be up late tonight knowing they just lost the ability to afford lifesaving care.”
Proposition 3 supporter Matt Slonaker, executive director of the Utah Health Policy Project, stated, “This bill is not perfect, and there are significant parts of it that we don’t support and will work hard to fix. But Governor Hebert, President Adams, and Speaker Wilson have stated that we will have an April 1, 2019 roll out date of coverage. UHPP, and our partners in the community, should be ready. We will finally be able to get coverage for Utahns that need it badly.”
The Utah Legislature also amended Proposition 2, the Medical Marijuana Initiative, which was approved by voters in 2018.