Utah moves forward with partial Medicaid expansion but faces an uncertain future

One of the reddest states in the country is moving forward with Medicaid expansion, but there's a couple of catches. 

Utah Gov. Gary Herbert signed a bill this week seeking to expand Medicaid in the state, but it doesn't go as far as traditional expansion, and he might have to wrestle with the Trump administration to get it approved. 

Expansion under the Affordable Care Act extends coverage for people under 138% of the federal poverty line, but Utah's proposal only provides up to 100% of the poverty line, about $12,000 for an individual or about $25,000 for a family of four. More than 60,000 people would be eligible for coverage under the expansion, according to the governor's office.

The new law also includes work eligibility requirements, following recent efforts by Kentucky, Arkansas and Indiana. The bill also includes a trigger mechanism that allows the Beehive State to rescind the expansion if the promised 90% federal funding rate ever drops. 

However, Utah's proposal faces an uncertain, and possibly rocky future.

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The Trump administration has been a vocal critic of Medicaid expansion, and that's where the proposal is headed next for federal approval.

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, however, recently said that the agency is required to accept Medicaid expansion applications. But that doesn't mean it'll be approved. 

"If a state files a state plan amendment, by law there is a certain period of time that we have to respond to that, and those are set in law," Verma said during an interview with reporters, as reported by the Washington Examiner. 

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The CMS head has given little indication on where she stands regarding partial expansion efforts, but some Republicans fear it will open the floodgates to allow more states to join, making the program more popular and sustainable. 

Utah is also not the first state to attempt a partial expansion. Last year Massachusetts asked the federal agency permission to move nondisabled adults with incomes above 100% of the poverty line out of the program and into subsidized commercial plans through the state's exchange. 

Arkansas has also applied for a federal waiver for a partial expansion. The administration has yet to make a decision on either request.