GOP lawmakers say they still hope for Medicaid deal but not sure if they'll have it by August

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SALT LAKE CITY — Republican lawmakers said Thursday they still hope to strike a Medicaid deal with Gov. Gary Herbert by August but aren't yet certain they'll meet that self-imposed deadline.

"Time will tell if we achieve it," state Rep. Jim Dunnigan of Taylorsville told reporters. "There's still a lot of work to do."

Dunnigan and Sen. Brian Shiozawa of Salt Lake City gave lawmakers on a health reform committee an update on the negotiations but offered few specifics about what a deal might look like.

In a statement, Herbert's spokesman Marty Carpenter said the governor is committed to working toward a solution that helps those in need while balancing the interests of taxpayers.

For more than two years, Utah officials have been debating whether to expand eligibility for Medicaid to help the state's poor and uninsured.

After failing to reach a deal during this year's legislative session, Herbert and Republican lawmakers pledged to find an agreement by July 31. After they reach a deal, Herbert plans to call a special session where lawmakers would consider the plan.

In addition to Dunnigan, Shiozawa and Herbert, the all-GOP group includes Lt. Gov. Spencer Cox, state House Speaker Greg Hughes of Draper and state Senate President Wayne Niederhauser of Sandy.

Democrats asked to be included in the group but were rebuffed. They said they can live with the arrangement if there's public debate on the proposal later.

The group has met about half a dozen times since forming in March, Dunnigan said.

Through a gap in President Barack Obama's signature health care law, an estimated 60,000 Utah residents living below the poverty line are ineligible for federal help paying for insurance.

They're not currently eligible for Medicaid either, but if Utah expands the program to include that group and those earning up to 138 percent of the federal poverty level, the federal government has agreed to pay most of the program's costs.

In Utah, it would cover a family of four earning about $33,500 a year or less. That's estimated to be about 126,000 people. If the state opens it up to fewer people, Utah will have to pay a larger share of the costs.

Dunnigan said one of the committee's chief concerns is that others states that have expanded Medicaid have seen enrollment and costs balloon beyond estimates.

If Utah expands, Dunnigan said the state could be on the hook to pay more than expected, even though most of the bill will be footed by the federal government.

Herbert arranged a tentative plan last year with the federal government that would allow Utah to use a chunk of federal money to enroll more of the poor in private health insurance plans. It mirrors similar proposals from other Republican governors pushing for a way to expand health coverage under the health care law while keeping it palatable to right-leaning legislatures.

Conservative lawmakers in Utah's House of Representatives rejected Herbert's plan, saying they fear the federal money may not be there down the road and the state may pay more than predicted.

Some object to covering anyone beyond the 60,000 in the gap because others are getting help elsewhere.

Dunnigan said Thursday that a Supreme Court decision expected this summer on other portions of the health law could drastically alter their talks.

The court's ruling threatens federal insurance subsidies helping about 140,000 Utah residents.

If those subsidies disappear, Dunnigan said that would shift how many people need help and could build more support for Herbert's plan.

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