The following testimony was given by Stan Rasmussen, Sutherland Institute vice president of government affairs. It was included as part of Senator Allen Christensen’s presentation of SB 96 3rd Substitute – Medicaid Expansion Adjustments on Wednesday, Feb. 6, 2019, before the House Business and Labor Standing Committee of the Utah Legislature.

Thank you, Mr. Chair, and good afternoon, Representatives. Stan Rasmussen with Sutherland Institute.

We commend the sponsor and those with whom he is working in their efforts to address the issue of Medicaid expansion pursuant to the passage of Proposition 3.

We are grateful that each of you and your legislative colleagues recognize that though there is an implicit expectation that you will be attentive to the interests and desires of Utah citizens – and of your individual constituents, in particular – there is an explicit affirmation you make in your oath of office: that you “will support, obey, and defend the Constitution of the United States and the Constitution of the State of Utah, and that [you] will discharge the duties of [your] office with fidelity.”

As each of us enjoy remarkable privileges as citizens living in this wonderful state, it is important that each of us remember that ours is a constitutional democratic republic, wherein by means of democratic processes we elect representatives to the state Senate and House, who are charged and authorized to develop sound public policy and laws, and frameworks for assuring fiscal soundness – policy and frameworks that form the civic foundations of functional culture in ways that are attentive to near-term issues and challenges, and especially to the long term.

I share this as an appreciative reminder that the decision of the Legislature to address and necessarily modify provisions included in Proposition 3 is most definitely not a matter of the Legislature ignoring the expressed interests of the people and it is not a usurping of the processes by which we, as a people, govern ourselves. It is the constitutionally established manner by which law and policy are developed in a constitutional democratic republic.

The Medicaid policies established in SB 96 are, overall, better than the alternative of just proceeding to implement Medicaid expansion envisioned by Proposition 3. Both Prop 3 and SB 96 are likely to impact access to health care for those currently in Medicaid because each would expand the pool of Medicaid enrollees with no provision to increase the number of doctors – especially specialists – willing to accept Medicaid patients, and with no changes or reforms that put Medicaid enrollees in the same kind of commercial health coverage that most of us would want.

Even so, problematic impacts of SB 96 are likely to be fewer than Proposition 3 due to the cap built into this proposal. Also on the plus side, the use of Medicaid funds for housing in SB 96 is likely to improve circumstances for certain Medicaid enrollees struggling with housing issues in ways that make Medicaid more effective. And the spending cap, eligibility limitation and lock-out period provisions of SB 96 will enhance the effectiveness of the program’s use of taxpayer dollars.

We support this effort to develop sound, long-term policy regarding the state’s Medicaid program.