10% of What?

"10% of what?"

That simple question has been chasing Utah’s coverage gap debate for the last few weeks.

And it makes sense to ask it.

If lawmakers pass the Healthy Utah plan, the federal government will pay for 100% of the expansion cost only for the first year. After that, the federal share drops incrementally from 100% to 90% until the year 2020 when the 90/10 match rate will remain in place. From then on the federal government will pay 90% of Utah’s costs for the program, while the state will contribute 10%.

So that’s why everyone is asking “10% of what?”

If the state is going to pay 10% of the total cost for closing Utah’s coverage gap, lawmakers need to know 1) How many people might enroll, and 2) How much it will cost the state.

But some people asking the 10% question make it seem like the state hasn’t crunched the numbers yet. They seem to suggest that "10% of something" is all we know. In other words, they make it seem like Utah is gambling with the state budget.

The fact is that Utah has already crunched the numbers on closing the state’s coverage gap.

We have solid projections not only on how many people are expected to enroll at each income level, but also what the state cost will be from 2016 to 2021. 
What is the state cost in 2021? $77.8 million. 
How many people are expected to enroll in new coverage by 2021? 146,000

The state of Utah, including the legislature, has ordered and commissioned more studies, reports, and surveys than anyone can keep track of. You can find and read many of them here at UHPP’s vast archives website.

The sheer number of these Utah-focused studies might be one reason some people never mention them or their findings. Or it could be that all of these studies, reports, and surveys—which rely on real numbers and accurate mathematical models—show that closing Utah's coverage gap with the Healthy Utah Plan is best strategy to create savings, encourage higher-quality care, and protect Utah taxpayers.

To help we’ve boiled down the key facts and numbers into this simple report, “What Do We Know about Utah’s Coverage Options?”(pdf)

Could Utah benefit from newer and more accurate studies on projected enrollment and state cost?

Yes. And those new studies are being developed right now.  

Should Utah’s enrollment estimates account for higher-than-expected uptake rates that occurred in Ohio and Michigan?

Absolutely. Plus, our projections should recognize that every state’s Medicaid program and eligibility requirements are different—resulting in different uptake rates, efficiencies, and state costs.

But to understand how closing the coverage gap actually works, we need to read and understand many important studies and reports that already exist … and not just claim that “10% of what” is too much and move on.

Because it turns out that we know a great deal about “…the what?” when it comes to closing Utah’s Coverage Gap.

What Do We Know about Utah’s Coverage Options? (pdf)