February 21, 2024
Nate Crippes / Public Affairs Supervising Attorney
ncrippes@disabilitylawcenter.org
Andrew Riggle / Public Policy Advocate
ariggle@disabilitylawcenter.org
(801) 363-1347 / (800) 662-9080
disabilitylawcenter.org
The Disability Law Center (DLC) opposes HB 463 because it suggests a Medicaid funding crisis is imminent. It then proposes cutting or eliminating critical services to Utahns as the only solution to a crisis that doesn’t exist. This is a false choice: in response to the unknown of the early stages of the pandemic, you and your colleagues demonstrated the ability to thoughtfully make difficult fiscal decisions using the tools you already have.
HB 463 defines what a Medicaid shortfall is, including a 2-point drop in our federal matching percentage. This is not a crisis. Our federal matching percentage will go down when we have a good economy. If this were truly about a doomsday scenario crisis, we would be talking about a 5–10-point drop, which would require congressional action. Nevertheless, the bill demands departments take drastic steps long before then.
Moreover, HB 463 allows for cuts if the Office of Legislative Fiscal Analyst finds we don’t have enough money to cover the costs of Medicaid or if Executive Appropriations has revenue projections indicating a resource problem. Several of the scenarios, even by mistake, could create a self-fulfilling prophecy, allowing cuts to optional services or enrollment, among other things. On top of this, the bill is silent about if or how people, services, or rates are restored once a “crisis” is over.
Optional services include the bulk of supports Utah Medicaid enrollees with disabilities and those who are aging depend on. They include things like prescription drugs, many home and community-based services, and some mental health or substance use disorder treatments. Clearly, “mandatory” and “optional” are simply terms of art. It bears no relation to whether a support or service is medically necessary or otherwise needed.
If HB 463 becomes law, the only choice for many might be more costly, but “mandatory,” inpatient or facility-based care. We also fear losing much of the progress made around mental health crisis response and building out wraparound supports to help individuals avoid such placements. Similarly, smaller expenses, like caregiver compensation, designed to keep people with their families and in their communities, could be at risk.
Utah’s Medicaid program is not in crisis, and there is not one right around the corner, other than the one HB 463 seeks to create. There are other bills this session looking to plan for the future of Medicaid. The DLC does not oppose those efforts. However, this bill is not contingency planning. Instead, it could decimate Medicaid simply because the state’s economy is strong.
If you are inclined toward support, please consider recommending HB 463 for interim study, so these and other concerns can be worked through.
Please do not hesitate to contact us with questions or for more information. Thank you for considering our perspective and position.