Utah’s quixotic Medicaid expansion plan, explained image

Vox, April 2, 2018
Dylan Scott, quoting Rachel E. Sachs (Academic Fellow Alumna)


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From the article:

Utah wants to expand Medicaid under the Affordable Care Act. Kind of.

The state legislature has passed and Gov. Gary Herbert has signed a bill that would partially expand Medicaid through the ACA — up to 100 percent of the federal poverty level (about $20,000 for a family of three) instead of the 133 percent threshold prescribed in the health care law. The Utah plan would also institute a work requirement.

According to Inside Health Policy, HHS is reluctant to approve the waiver because officials are worried about drug companies suing over the policy and winning and/or they are concerned that every other state would follow suit if Massachusetts is allowed to set up a formulary.

These rationales were unsatisfying to health policy Twitter. I’d suggest reading this thread from Washington University in St. Louis’s Rachel Sachs. She wondered: If the reason for rejecting the waiver is that HHS doesn’t have the legal authority, why not say that directly?

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health care reform health law policy medicaremedicaid pharmaceuticals public health rachel sachs