SALT LAKE CITY — Republican members of Utah's House of Representatives are crafting a plan for a partial Medicaid expansion that appears to fall short of Gov. Gary Herbert's intention and could lead to an impasse over the issue.
The House GOP plan eschews more than $500 million in federal money and instead uses state dollars to partially expand the program. House Republicans say that's the responsible thing to do because it keeps the state from becoming more dependent on federal money that may not be there down the road.
"When we partner with an unsustainable funding source with the federal government, we are not in control of our destiny as a state," House Speaker Becky Lockhart, R-Provo, told reporters Wednesday.
Herbert, also a Republican, called that "illogical" because Utah residents send tax dollars to the federal government, so they deserve to have some of that money returned to the state.
"The Utah taxpayer should not have to pay more and help fewer people," Herbert said at his monthly televised news conference Wednesday morning.
Herbert said he will release details of his own decision on the issue within 10 days.
But House Republicans decided to jump into the fray Tuesday by revealing their preferred plan, which they say would use about $30 million to $35 million in state money to help the most vulnerable uninsured residents get coverage.
Lockhart said the proposal is something she and other House leaders have been working on for some time, but they're not sure what portion of the 60,000 uninsured they would cover and when the plan would appear as legislation.
Under the federal health care law, states have the option of expanding eligibility for Medicaid, the state-federal program for low-income people. If states fully expand the program to include people making up to 138 percent of the federal poverty level, the federal government has offered to pick up the full cost through 2016 and 90 percent after that.
Utah is one of several states considering Medicaid expansion this year.
Among the others are: New Hampshire, Pennsylvania and Virginia. Arkansas' plans are in flux, too, after state legislators there failed to approve a plan to use Medicaid funds to purchase private insurance for thousands of low-income residents.
Because of a gap in the health care law, there are about 60,000 Utah residents below the federal poverty level who are not covered by Medicaid or eligible for federal subsidies to pay for private insurance.
Herbert has said that doing nothing on the issue is not an option and that he would like to see Utah find a solution that covers all 60,000 below the poverty line. "There's a moral obligation, I think, that we have as a state and a government to help those people in any way that we can," Herbert said.
Herbert said he's still working behind closed doors with both the House and Senate to find a plan. But if they can't come to an agreement, he's willing to use his role as governor to make a public push for his path.
"I'm prepared to make sure we get the right outcome," Herbert said.
In Arizona, Republican Gov. Jan Brewer's push to expand Medicaid has led to a prolonged struggle with that state's Republican-controlled Legislature. The battle eventually ended up in court, with GOP legislators filing a lawsuit to stop the expansion.
Utah Democrats on Wednesday commended the push by Brewer and other governors who have chosen to expand.
Sen. Jim Dabakis, a Salt Lake City Democrat and chairman of the state Democratic party, called on Herbert to have "the moral courage necessary" to lead Utah to some form of expansion that accepts the federal money, if not full expansion.
"To turn that money down on some ideological pretext is simply the wrong thing," he said.
He and other Democrats called the House plan irresponsible and political posturing.
"Why now when we've been having this conversation for the last year and a half?" said Sen. Luz Robles, D-Salt Lake City. "It's not about the policy anymore. It's something else."
Senate President Wayne Niederhauser, R-Sandy, said Senate Republicans are still working through the issue.
Niederhauser said GOP members in his chamber are concerned about relying on federal dollars, but he also said there's an argument to be made for returning tax money to Utah.
There are also concerns about the state doing all it can to help people get health care, he said.
"I don't think any American wants to see people that need health care that are unable to get that," Niederhauser said. And I think that's an important element in this discussion."
Associated Press writer Annie Knox contributed to this report.