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‘Will of the voters’ goes deeper than one ballot initiative

Written by Derek Monson

February 14, 2019

Medicaid expansion proponents characterize the Utah Legislature’s approval of a modified Medicaid expansion, referred to as SB 96, as defying the will of the voters on Proposition 3. The truth is, Utah legislators did exactly  what voters elected them to do: pursue constitutional, compassionate and conservative health care policy.

The will of the people can be difficult to pinpoint. For example, the same voters who passed Proposition 3 also voted to elect or re-elect the very legislators who just passed SB 96. Many of those legislators were also re-elected after opposing Medicaid expansion in the past. It is an overly simplistic disservice to the public to try to convince them that their vote on a ballot initiative was an expression of their will, while the actions of the legislators they voted for is something completely different.

This kind of thinking only makes sense from the perspective of out-of-state donors behind Proposition 3, who feel they have to watch as duly elected Utahns tinker with the initiative these donors bought and paid for. The more reasonable argument is that voters wanted Medicaid to expand, but also want legislators to do what they are elected to do.

Passing SB 96 fulfilled the solemn constitutional duty of state legislators to properly manage and balance the state budget on behalf of taxpayers. The best numbers available project that Proposition 3 would start ruining the state budget in just a few years. For that reason alone, it had to be modified. The will of the people – as expressed by their state constitution – is for their elected representatives to balance the state’s budget on their behalf.

SB 96 is also a compassionate policy on the same terms as Proposition 3: It left no one out. While Proposition 3 gave Medicaid coverage to the “coverage gap” – everyone whose income was too high for Medicaid, but too low for Obamacare’s insurance subsidies – it would have taken insurance subsidies from tens of thousands of Utahns and put those Utahns into Medicaid. That’s not exactly the compassion that was sold on Prop 3 billboards last November. SB 96, on the other hand, extends Medicaid coverage to the coverage gap, without taking away another Utahn’s health coverage.

Finally, SB 96 is grounded in reality, with prudent guardrails and limitations – typical of conservative approaches to public policy. Part of that reality is that the voters chose to expand Medicaid, which SB 96 does. The reality of Proposition 3 is that it contains unintended consequences, like budget imbalances and the revocation of insurance subsidies. SB 96 addresses those, but in a well-defined, limited fashion (e.g., caps on spending, seeking waivers for taxpayers before expanding). That kind of prudence doesn’t make SB 96 the only or the best approach, but it does mean that it falls into the conservative policy spectrum reflecting the ideological makeup of the citizens of Utah.

There will be many and varied opinions on the merits of the Utah Legislature’s response to Proposition 3. But for those speaking in opposition to SB 96, there is an obligation to the public to at least characterize that approach accurately.

Some may not like SB 96, but it fulfills lawmakers’ constitutional duty. Some may not agree with SB 96, but it is a compassionate approach to Medicaid expansion. Some may reject SB 96, but it is a conservative policy that arguably reflects Utahns’ ideological preferences. And all of those things, to some degree, are an accurate expression of Utahns’ will.

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