Good afternoon,

It has been a hectic few weeks of whirlwind Utah Medicaid news, and we wanted to provide an update and a call to action.

Reminder of where we have been:
  • Voters approved full Medicaid expansion via the Proposition 3 ballot initiative in November 2018
  • The successful initiative also included a small non-food sales tax to fund the expansion
  • Lawmakers repealed and replaced that initiative with SB96, a complicated 4-phase expansion plan*, in February 2019
  • The Trump administration announced its denial of SB96's partial expansion on July 26th
Where we are now:

As of now, the state is proceeding with SB96. They have submitted the phase 2 Per Capita Cap waiver, and plan to proceed with Phase 3, the Fallback Plan*.

However, every day we wait we are paying three-times more to cover fewer people, and so we are asking Governor Herbert to instruct the Utah Department of Health to file a State Plan Amendment right away to implement full Medicaid expansion FIRST, instead of prioritizing the harmful caps and red tap in the waivers.

Next steps/call to action:

Call on Governor Herbert to proceed with full Medicaid expansion right away without harmful barriers like work reporting requirements or enrollment caps.
Call his office at 801-538-1000, and then use this form to send a message to your legislators.

Visit to fill out a brief survey to submit a public comment against enrollment and per capita caps and work reporting requirements.

For currently-eligible or enrolled individuals, nothing changes. We need to continue encouraging folks to reach out to 2-1-1/ to sign up or ask questions
*Reminder of what is in SB96:
  • Phase 1, the "Bridge Plan" rolled out on April 1st. That phase included a partial Medicaid expansion plan: expanding eligibility for people below 100% of the Federal Poverty Line (approximately $1000/month for an individual). The state agreed to pay 32% of the cost instead of the 10% share under full expansion, and allocated additional funding to cover that share until June 2020.
  • Phase 1 also included permission to add an enrollment limit and a work reporting requirement, set to roll out in 2020.
  • Phase 2, called the "Per Capita Cap Plan" was introduced in May 2019. That phase included a request for an enrollment limit, a work reporting requirement, a per capita cap (limit on funding received from the federal government in exchange for permission to cut people and services from Medicaid), as well as a request for the enhanced match rate, which would reduce Utah's share of the bill from 32% to 10%.
  • On July 26th, it was revealed that the Trump administration would be denying the partial expansion portion of the pending Per Capita Cap waiver.
  • Utah proceeded anyway, and submitted that waiver request on August 1st.
  • Therefore, we still need to continue collecting public comments on the harmful caps and red tape barriers contained in that waiver.
  • Phase 3, the "Fallback" Plan is a full Medicaid expansion up to 138% of the Poverty Line, with the 90/10 federal match. However, that plan still asks for an enrollment cap, a work reporting requirement, and other changes to a traditional expansion.
  • Phase 4, the "Full Expansion" Plan is in line with Proposition 3. It is a full expansion up to 138% with the 90/10 federal match, without strings attached. This phase also accounts for any fiscal concerns associated with Proposition 3, by removing a provider pay increase that was in the ballot initiative. This plan started as Rep. Ray Ward's HB210, and was added into SB96 due to the hard work of advocates. 


Utah will not be able to proceed with a partial Medicaid expansion. The state should move forward right away, prioritizing full Medicaid expansion without caps and red tape. Tell your elected officials that there is no reason to delay and continue to spend three-times more to cover fewer people.
Thank you for your continued advocacy,

Stacy Stanford

Health Policy Analyst
Utah Health Policy Project
Call or Text- (801) 718-6130