CMS approves Utah’s partial Medicaid expansion plan

The Centers for Medicare & Medicaid Services gave the OK to Utah’s request for a partial Medicaid expansion. 

Voters in the state approved expansion through a ballot measure last year, and Utah officials requested a “bridge” expansion that would begin April 1, so that it could begin enrolling people in the program as it awaited additional funds from the Trump administration. 

In a tweet announcing the approval, CMS Administrator Seema Verma congratulated Utah Gov. Gary Herbert on “designing at Utah solution that offers greater sustainability while underscoring the continued importance of local innovation and control in Medicaid.” 

She said it was an “innovative program designed to improve health and lift Utahns from poverty through community engagement.” 

RELATED: Azar says HHS talking with states interested in Medicaid blog grants 

The state intends to have a request for a long-term Medicaid expansion program submitted in short order, state officials said in an announcement

Utah is planning to roll out work requirements—as Verma noted in her post—and they’re include both in the bridge plan and in a long-term one. However, these work requirements would not be enforced until January at the earliest. 

In both plans, the partial Medicaid expansion would increase eligibility to 100% of the federal poverty level, instead of 138% as allowed under the Affordable Care Act. That will add between 70,000 and 90,000 people to the rolls, while 150,000 residents would be eligible under a full expansion. 

“This is an important first step in covering vulnerable Utahns in a financially sustainable way,” Herbert said in a statement. “ 

RELATED: National Health Law Program—Medicaid work requirements are bad policy disguised as flexibility 

CMS approved the plan—including the work requirements—just days after a federal judge threw water on work requirements in Kentucky and Arkansas. Judge James Boasberg ruled that the agency had failed to consider the impact of work requirements on coverage in its approvals, and as such did not consider how that plays into the program’s central goal. 

Verma said in a statement in response to the ruling that CMS would not abandon work requirements despite the ruling, and policy experts said interested states were likely to stick with such plans as well

However, the rulings do open the door for litigation in other states, the industry watchers said, and does hold implications for a pending suit challenging work requirements in New Hampshire, which is also before Boasberg.