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Friday, May 30, 2014

How Medicaid Expansion Affects Salt Lake County

In 2011 the Supreme Court upheld the Constitutionality of the Affordable Care Act (commonly known as Obamacare) with one exception: Medicaid expansion. States could now choose whether or not to expand Medicaid coverage. 

Utah has already been taxed heavily (to the tune of $680 million) and sent those dollars to Washington, DC. If Utah chooses not to expand Medicaid or accept those dollars in a different form, Salt Lake County will have two choices: cut county behavioral health and substance abuse programs, or raise taxes to continue funding them. Here are the current options being explored by the Governor's office, Utah Senate, and Utah House:

Instead of expanding Medicaid, Governor Herbert came up with a plan to still keep some of the funds coming to Utah. (Remember, these are taxes that you and I have already paid. If Utah doesn’t take them, then other states will get to have the funds.) The Governor’s Healthy Utah Plan is designed to cover those 111,000 (about 50,000 in Salt Lake County) people under private insurance, without expanding the Medicaid roles. Only those determined to be medically frail would move to Medicaid coverage. 

Every month Utah waits, $4 million of our tax dollars go to other states. What makes Utah’s plan unique is the Governor asking for the money from the federal government to come in the form of a $258 million block grant. The state would use that to provide care and manage those who fall in the “donut hole”* of coverage, which are some of the neediest in Utah who don’t qualify for Medicaid, but can’t afford traditional coverage. Typically these are people who are at or below 133 percent of the poverty line or make less than $15,500 per year. Our coverage of those incarcerated in our jail also goes from 20 percent of inmates covered to 80 percent of inmates covered. Healthy Utah provides assistance to pay for health insurance on private markets. The exact amount depends on four factors:
Ability to work
- Household income
- Access to employer or family health insurance
 - Individual health care needs

No matter what happens, Salt Lake County will be affected. If we take funds through the Governor’s Healthy Utah Plan or by expanding Medicaid we will be able to provide health coverage for the poorest of the poor and continue the county’s substance abuse program. Our substance abuse program helps to keep people out of jail, which then saves taxpayers money.

If we don’t accept these funds, Salt Lake County will be forced to significantly raise taxes to continue funding the substance abuse program, or risk cutting the program. This could still mean increased costs through additional incarceration of substance abusers who can’t get the help they need.

*Salt Lake County’s uninsured estimates

Tuesday, May 27, 2014

Welcome to my blog!

As I've been serving on the Salt Lake County Council, I've had fun meeting people, speaking at functions, and talking to community leaders. One thing that has surprised me is how little most people know about Salt Lake County. This blog is an effort by me and my council aide, Adam Gardiner, to help educate constituents about county government. We'll be sharing information on general county issues and hot topics.

Salt Lake County acts as a municipal government for the unincorporated areas like Millcreek, Kearns, Magna, Copperton, White City, and Emigration Canyon. We handle things that cities take care of in other communities - road repair, snow removal, garbage collection, public safety, planning and zoning, etc.

In addition to being the municipal government for the unincorporated areas, we also are a regional government for the entire Salt Lake Valley. The county owns facilities like Clark Planetarium, Wheeler Farm, Salt Palace, South Towne Expo Center, Discovery Gateway, Rose Wagner Performing Arts Center, Abravanel Hall, Capitol Theatre, and the Salt Lake Arts Center. We also have numerous parks, rec centers, and golf courses scattered throughout the valley.

The county Human Services functions vary from Aging Services (Senior Centers, Meals on Wheels, in-home services, etc.) to Behavioral Health, Substance Abuse, Criminal Justice and Youth Services. We even have the Health Department and Library Services. (One of the top library systems in the nation, I might add.)

The county budget is almost a billion dollars, with much of that budget going to fund the jail and other public safety measures.

We look forward to sharing information to improve transparency and constituent outreach. Check back often!!