Payer Roundup—Utah takes another step toward slimmed-down Medicaid expansion

Utah's legislators have taken another step toward slimming down the state's voter-mandated Medicaid expansion, plus more insurance news. (Getty/designer491)

Utah one step closer to trimming back voter-mandated Medicaid expansion 

Utah’s state House has approved legislation that would scale back the number of people eligible for the voter-mandated Medicaid expansion. 

Voters in the state approved Medicaid expansion in the 2018 election, and under the Affordable Care Act that would allow the state’s program to add people making up to 138% of the poverty level to the rolls. However, the newly passed House tweak would cut that to 100% of the poverty level. 

Such a change would need to be approved by the Centers for Medicare & Medicaid Services before being finalized. The state’s Senate and governor would also need to sign off on the plan. 


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“We’re doing the very best we can, and I think we’ve got a great solution here,” Stuart Adams, president of the state’s Senate, said. (The Associated Press

Texas payers, businesses, consumers call for end to surprise billing 

Some of Texas’ insurers, businesses and consumers have joined forces to push for an end to surprising billing. 

The Texas Association of Health Plans (TAHP), AARP Texas and Texas Association of Business signed a joint statement calling for the practice to end, as it is especially common in the state for emergency care. The statement calls for an end to surprise bills that also ensures providers are fairly paid. 

“We still see it over and over again in the news—Texans consistently receive outrageously high surprise medical bills for healthcare they receive in an emergency,” TAHP CEO Jamie Dudensing said. “We are committed to working with the legislature this session to put an end to surprise billing and make sure patients are no longer held hostage during these billing disputes.” (Announcement

CMS Administrator Seema Verma’s next test—Medicaid in blue states 

The Trump administration has offered avenues for red states to tweak their Medicaid programs—but now that governors’ offices have flipped to the Democrats, they could seek similar leeway for more liberal reforms. 

CMS Administrator Seema Verma has sought to allow states greater control over their Medicaid programs, but it remains to be seen if that perspective will extend to more expanded public insurance options. 

“It’s really going to be a test,” Chris Sloan, a director at Avalere, said. “Does flexibility go to everyone or is it just for cheaper, less regulated insurance? This has yet to be decided.” (The Wall Street Journal

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