Capitol Daily Memo: The facts on SB 208 (Health Care Compact)

The Utah Senate passed SB 208 today, 21-8, and it now moves to the House for consideration. If passed, SB 208 would make Utah a member of the Health Care Compact, an interstate compact that would restore authority and responsibility for health care regulation to Utah and other member states, and it would provide the funds to the states to fulfill that responsibility. In other words, Utah would have the power to suspend and supersede any federal health care regulation, including for Medicaid and Medicare, but excluding those for Native Americans and those provided by the federal Departments of Defense and Veterans Affairs.

Will the Health Care Compact tie Utah to poorly performing health care states?

Answer: No, it will not. Other than offering Utah to be part of a multi-state advisory board, SB 208 will not link or obligate Utah to other states in any way. Rather, under the Health Care Compact, Utah will have the discretion to design and operate its health care programs in ways that are best for Utahns. Further, the state would be free to leave the compact at any time.

Will SB 208 put power over Utah health care policy in the hands of an interstate commission? 

Answer: Again, the answer is no. The Health Care Compact establishes an Interstate Advisory Health Care Commission (IAHCC), which is just what its title implies: an advisory body. Just like the dozens of advisory boards thatUtah has created, nothing that IAHCC does is binding on Utah. The role of the advisory commission is to study pertinent health care issues, publish information on the cost of health care, and make non-binding recommendations to member states.

Why should Utah join the Health Care Compact now?

Answer: By joining the compact now, Utah ensures that it will have a seat at the table to speak for itself when enough states join the compact to negotiate with Congress and force congressional action. Waiting until the future to join, on the other hand, risks the possibility that someone other thanUtah policy leaders will set the future terms of state health care programs – the exact problem that currently undermines so many potential health care policy solutions. Supporting SB 208 really comes down to answering a basic question: Do you think Utah is better able to address the health care needs of its citizens than federal bureaucrats in Washington,D.C.? If your answer is “yes,” then it makes sense to support SB 208-Health Care Compact now, with no delay.

Will Utah have less money to spend on Medicaid?

Answer: One of the primary benefits of joining the Health Care Compact is that Utah will be able to run its Medicaid program free of wasteful, one-size-fits-all federal mandates and without the “brokerage fee” that Washington,D.C., exacts before sending Medicaid funds to Utah. In other words, SB 208 will mean that the state can spend less on mandates from federal bureaucrats who have little to no knowledge of what is best for Utahns, and it will have more funds to spend on actually improving the health of those on Medicaid. We agree with Senate President Michael Waddoups and former House Speaker Dave Clark that Utah should “take over [Medicaid] entirely,” because Utahns would be better served by a Medicaid program that is run “more efficiently and productively without federal strings and mandates.”

Will the Health Care Compact undermine Utah’s 2011 Medicaid reform plan?

Answer: No, it will not. Perhaps the most telling fact is that the sponsor of those reforms, former Senator Dan Liljenquist, was himself the original sponsor of SB 208 before resigning to run for the U.S. Senate. Far from undermining Utah’s Medicaid reform plan, SB 208 will actually make it easier for Utah to move forward with its Medicaid reforms by allowing them to roll forward without requiring permission (or allowing interference) from Washington, D.C. The Health Care Compact is arguably the best way for Utah to implement its preferred Medicaid reforms.

Will the Health Care Compact mean a bigger health care bureaucracy in Utah?

Answer: The irony of this question is that it is being raised most ardently by those who constantly advocate for more government in the health care arena. As an organization grounded in conservative principles, Sutherland Institute does not support policies that unreasonably increase the size of government. Federal inaction in the face of dire fiscal projections for Medicare indicates that federal lawmakers are content to divert their attention while Medicare goes bankrupt. Protecting the health care ofUtah’s 280,000 Medicare recipients from Washington, D.C.’s impotence and incompetence may require more state-government employees, and it is the right thing to do. Further, with the state’s ability to run programs more efficiently than the federal government, whatever growth in government does happen will still be a better use of tax dollars. The alternative is to leave the lives ofUtah’s seniors and other residents in the hands of federal bureaucrats and politicians whose primary concerns are their own power and their next election.