Major health care reform bills to be heard in committee Wednesday

On Tuesday, two significant health care reform bills came out of the House Rules Committee.

•        SB 164 (1st Subst.) – Access to Health Care Amendments, sponsored by Sen. Brian Shiozawa, is Governor Herbert’s proposed “Healthy Utah” plan.

•        HB 446 – Extension of Primary Care Network and Medicaid Benefits Under Existing 70/30 Federal/State Cost Sharing Amendments is the “Utah Cares” program proposed by Rep. Jim Dunnigan.

The two bills have been assigned to the House Business and Labor Committee, where they will be the only two items on the agenda when the committee meets on Wednesday evening, March 4, at 6 p.m.

Assignment to this committee is consistent with the pattern established several years ago subsequent to the passage by the U.S. Congress of the “Patient Protection and Affordable Care Act,” generally known as Obamacare. And, as I have observed through lengthy personal association with the Legislature’s Health Reform Task Force, health care reform related bills are assigned to and considered by this committee. Recent examples include last year’s HB 141 – Health Reform Amendments (2014) and HB 160 – Health System Reform Amendments (2013). Additionally, it is as appropriate for a bill to go to a committee that interacts with entities that deal with liabilities and costs as it is for a bill to be sent to a committee that interacts with entities that reap benefits associated with proposed legislation.

Sutherland has steadfastly opposed the “Healthy Utah” proposal. The Institute sees significant merit in the proposed “Utah Cares” bill. Readers are encouraged to familiarize themselves with these bills and communicate their views with their elected representatives.

Support religious liberty: stand up to the ‘no compromise’ approach to nondiscrimination

Utah_State_Capitol_2008Supporters of a “no compromise” approach to LGBT nondiscrimination argue that we already have sufficient protections for religious liberty. They cite the First Amendment and Utah’s majority-Mormon population to bolster their case. Unfortunately, their argument is undermined by the realities of “no compromise” approaches to nondiscrimination law.

The facts and details of the experience of a Salt Lake City police officer and his role at the Salt Lake pride parade in 2014 are a case in point. This officer arranged, as is common police practice, a swap of duties with another officer working the parade. In the officer’s view, his original entertainment/celebratory role of doing motorcycle maneuvers at the head of the pride parade amounted to endorsing values that his conscience and faith disagreed with. Instead, the officer sought to perform a public safety role, such as protecting parade watchers from traffic. The officer had fulfilled similar public safety duties on other occasions for Salt Lake LGBT rallies.

Because the officer had the temerity to ask that his religious views and values be treated with tolerance, respect and equality, his employer caricatured him as a bigot to the media, questioned his willingness to perform his duty and put him under internal investigation. This officer asked for religious liberty and was met with injustice and intolerance. And all of this happened in our own backyard. Read more

Nondiscrimination legislation requires balance, extreme care

Balancing_act_News reports suggest there is still an ongoing debate about how to balance calls for changes to state discrimination laws (which would expand the reasons businesses and property owners could not deny housing or employment) with the need for robust religious liberty protections.

At the time leaders of The Church of Jesus Christ of Latter-day Saints held a press conference calling for laws protecting religious liberty, Sutherland Institute noted its support for the balanced approach the church endorsed.

It is safe to assume that few, if any, people of faith in Utah want anyone to be denied a job or a place to live just because those people’s actions or beliefs are contrary to the beliefs of the religion. Religious groups, both churches and charities operating in accordance with religious principles, merely want to ensure that those who represent them as leaders and employees live lives consistent with those principles.

Sutherland Institute has consistently urged strong religious protections that allow churches, unaffiliated religious organizations and individuals to live in accordance with their religious beliefs in every aspect of their lives. Any legislation on this topic should protect this vital principle.

At the same time, the Legislature needs to exercise extreme care when introducing new terms, like “sexual orientation” or “gender identity,” into the law.

The latter requires particular caution since definitions in previous legislation could be read to allow a person to identify as a person of another sex for short periods of time, going back and forth between genders and asking for accommodations in facilities, etc., possibly from day to day. Legislation should be crafted to provide clarity and prevent undue burdens on employers or the privacy of employees, customers, and others.

Even the “sexual orientation” language, if not appropriately qualified, can present challenges for religious liberty. Read more

Testimony on SB 153 (Access to Health Care)

sutherland file pictures 007Testimony presented by Stan Rasmussen, Sutherland Institute director of public affairs, on Feb. 17, 2015, before the Senate Health and Human Services Standing Committee regarding SB 153 (Access to Health Care): 

Thank you, Mr. Chair, and good morning, Senators. Stan Rasmussen representing Sutherland Institute.

We think SB 153 represents a wise approach that balances meeting the immediate needs of individuals with significant health problems against the need to be cognizant of and cautious about the very detrimental impact that expanding the Medicaid program will have on those currently in Medicaid – the hundreds of thousands of disabled individuals and low-income single parents and children that Healthy Utah would leave behind in traditional Medicaid – as well as on the long-term fiscal outlook of the state.

For these reasons, we strongly encourage your support of this bill.

Thank you.

On Point video: Taxes and education in the Legislature — 2/12/15


Watch as Utah GOP party officer Michelle Mumford and political consultant Michelle Scharf discuss the latest in Utah politics and the 2015 Legislature in this edition of On Point presented by Sutherland Institute.

Click the image above to watch, or if you prefer a podcast, it can be found at the bottom of this post.

You can watch all the half-hour On Point videos here on Sutherland’s YouTube channel.

Use this link to subscribe to the On Point podcast on iTunes.

Or use this link to subscribe to the RSS feed.

Testimony on SB 164 (Medicaid expansion)

sutherland file pictures 007Testimony presented by Derek Monson, director of public policy, Sutherland Institute, on Feb. 11, 2015, before the Senate Health and Human Services Committee of the Utah Legislature regarding SB 164 (Access to Health Care Amendments):

Thank you, Mr. Chair and members of the committee. I am Derek Monson, policy director for Sutherland Institute, and I appreciate the opportunity to present our viewpoint on this important issue to you.

I would like to draw your attention to what we think is a basic policy issue regarding Senator Shiozawa’s bill. That is its impact on the people for whom the Medicaid program was actually designed to serve: disabled Utahns and low-income single parents and children.

Both thoughtful analysis and fact suggest that Sen. Shiozawa’s bill will increase the difficulties and suffering of the more than 300,000 disabled Utahns and low-income single parents and children currently in Medicaid. This is not a partisan or ideological issue. While Sutherland recognizes this problem, so do nonpartisan research organizations that argue in favor of Medicaid expansion, such as the RAND Corporation.

Neither is this just a theoretical question. In Oregon, so many people were added to the ranks of the insured through Medicaid expansion, basically overnight, that doctors and hospitals were forced to “lock out” Medicaid patients and make them “wait months for medical appointments,” as reported by the Associated Press. And in Arkansas, which expanded Medicaid using private insurance subsidies just like Healthy Utah envisions, a legislative committee heard testimony last April from state officials that providers are more “anxious” to serve newly privately insured patients than traditional Medicaid patients.

And why shouldn’t they be? In Arkansas as well as in Utah, the typical private insurance policy pays providers better than Medicaid does. And as basic economics teaches us, people respond to price incentives. The enactment of Healthy Utah clearly says to providers that they ought to prioritize the health care needs of the estimated 89,000 Medicaid expansion enrollees over the needs of the 300,000 single mothers, disabled Utahns and children left behind in traditional Medicaid. Utah’s most vulnerable will find it more difficult to find a doctor, and they will suffer longer waiting in line for needed surgeries and more intensive health care services.

Good public policy, on the other hand, would put traditional Medicaid enrollees on the same health care access footing as Medicaid expansion enrollees and everyone else, rather than excluding them and by so doing making their lives worse. Additionally, good public policy would not say to uninsured Utahns that we intend to care for their needs, only to toss them into the street the moment Washington, D.C., gets jittery about their finances. We don’t think that reflects the Utah values of providing service and helping to our neighbors in need, even when it’s difficult to do so.

In short, if “doing the right thing” means putting Medicaid expansion on the backs of disabled Utahns, single mothers and their children, then this is the bill for you. If, on the other hand, you think that serious public policy proposals should recognize and address the negative impacts they are likely to have on Utah’s most vulnerable, then I would encourage you to not vote in favor of SB 164 until it at least includes some attempt to address this critical issue.

Thank you.

Senator Hillyard has it right on raising the rainy-day fund cap

Utah_State_Capitol_2008Last week, Senator Lyle Hillyard posted to The Senate Site that he and Representative Dean Sanpei would be sponsoring legislation to raise the limits on the general and education rainy-day funds (or budget reserves) which are currently at 8 percent and 9 percent of the previous year’s budget, respectively. Their proposal would raise these limits to 9 percent of the last year’s budget for the general rainy-day fund, and 11 percent for the education rainy-day fund.

This proposal is the right thing to do for Utah taxpayers and families. It is prudent and wise fiscal policy, and Sutherland Institute supports it.

First, as Sen. Hillyard correctly notes, this policy change will “help us live and provide a stable budget in less-certain times.” As Utah’s experience during the most recent recession suggests, having a healthy source of one-time funds set aside in savings gives policymakers the flexibility and financial cushion needed to make modest (and healthy) cuts to government spending. Just as important, if not more so, building up sufficient savings protects Utahns from being forced to accept truly harmful policies – such as deep spending cuts to essential programs and services and/or significant, economically damaging tax increases.

In other words, having significant one-time savings set aside protects recession-ravaged Utah taxpayers and families from further short-term harm, such as cuts to things like safety-net services. It also protects them from spending cuts or tax increases that generate short-term gain (balancing Utah’s budget) in exchange for long-term loss (fewer jobs, less household income and slower economic growth).

Second, while Utah’s pre-recession rainy-day fund savings were significant, the Great Recession showed that they were, by themselves, inadequate. The recession required policymakers to end or reallocate certain one-time budget items – cash-funded road and building construction/maintenance, for example – instead of further cutting other government programs and services. In effect, these one-time budget items were treated as informal rainy-day funds, in order to avoid more damaging spending cuts elsewhere. There is no guarantee that these fiscal cushions will be available in the future. For instance, economic circumstances or other spending needs may not allow the Legislature to return to previous levels of cash funding for roads and buildings. This makes lifting the caps on rainy-day funds a prudent way to maintain sufficient budget reserves in the face of this uncertainty.

For these and other reasons, Sutherland Institute supports the Hillyard/Sanpei proposal to raise the current caps on state rainy-day funds. We hope that the Legislature and the governor will enact this prudent fiscal policy change into law.

A right to discriminate?

ReligiousSymbolsA common accusation made by those who oppose robust protections for religious liberty is that proponents are seeking a “right to discriminate.” The common form this argument takes is that religious liberty is already protected (say, by the First Amendment to the Constitution: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof”) so any other concession is asking too much — it would be dangerous or scary, a license to pick and choose what laws to comply with*; it would be a right to discriminate.

Discrimination in this context is, basically, denying a person a job or a place to live or refusing to provide goods or services normally provided in the course of doing business.

To assess the validity of this accusation, some background is helpful, though necessarily I will paint with a broad brush. Religious people believe they are accountable to God in every aspect of their lives. Acting on this principle is what constitutes the “exercise of religion.” There are at least five possible categories of organizations or people who could benefit from religious liberty protections.

First are churches. The basic liberties they seek are to teach their doctrines, provide sacraments or ordinances, build and maintain places of worship and select official representatives (clergy) without interference. These aims, which may be thought of as the core religious rights, are typically protected by interpretations of the U.S. Constitution. For instance, in 2012, a unanimous Supreme Court rejected a claim from the federal government that it should be able to second-guess a church selection of a teacher in a religious school. The fact that the current administration pushed this attempt all the way to the Supreme Court is concerning, but that claim lost and there’s reason to believe that at least for now, these core religious functions are protected from direct government interference.

That’s not to say there won’t be non-governmental interference with these function, like vandalism, threats, slander, etc. Read more

On Point video: 2015 Legislature gets into its groove

Watch “Holly on the Hill” blogger Holly Richardson and Michelle Mumford, former assistant dean at BYU Law School, discuss the first week of the 2015 Legislature – including the topics of Medicaid expansion, gas tax, police-community relations, education funding, religious freedom and nondiscrimination legislation – during the latest On Point broadcast. Click the image above to watch, or if you prefer a podcast, it can be found at the bottom of this post.

You can watch all the half-hour On Point videos here on Sutherland’s YouTube channel.

Use this link to subscribe to the On Point podcast on iTunes.

Or use this link to subscribe to the RSS feed.

2015 Legislature: Testimony supporting partisan elections for state school board (SB 104)

TUtah_State_Capitol_2008estimony given by Stan Rasmussen Tuesday, Feb. 3, before the Senate Government Operations and Political Subdivisions Standing Committee regarding Education Elections and Reporting Amendments (SB 104):

Sutherland supports SB 104 because it would replace the current incoherent, convoluted and complex state school board election system with one that produces clarity, transparency and accountability for voters and parents of children in public schools.

The system proposed in SB 104 produces clarity for voters and parents by giving them the same system to select state school board members that they use for every other state elected official in Utah. This system produces transparency by adding to state school board elections the heightened media scrutiny that partisan elections create through a narrative of partisan competition, as well as the heightened voter scrutiny that comes with the caucus-convention-primary system. Finally, this system produces accountability by incorporating voters and parents into every stage of the election process, rather than just after the candidate pool has been winnowed down, as the current system does.

In closing, you have heard today, and previously, that utilizing partisan elections to select state school board members is bad policy because it injects partisan politics into the state school board. Perhaps an appropriate response to this argument is a paraphrase of Winston Churchill: “[I]t has been said that [partisan elections] are the worst form of [elections] except all … other forms that have been tried.”

We encourage you to support SB 104. Thank you.