Utah governor wary of health law repeal without replacement

SALT LAKE CITY — If Congress repeals President Barack Obama’s health care law without having a replacement plan ready, it could jeopardize coverage for about 180,000 Utah residents, Utah’s Republican governor has cautioned.

Gov. Gary Herbert made the warning last week in a letter to U.S. House Majority Leader Kevin McCarthy, of California, who asked the nation’s governors for input as the GOP-controlled Congress takes steps to dismantle the 2010 Affordable Care Act.

Herbert’s office provided the Associated Press a copy of his letter.

Herbert, who was not a supporter of the law, wrote that he understands a replacement could take years to plan and implement, but “Utah’s citizens cannot wait for such a lengthy process.” Herbert said Congress needs to be cautious, but that he’d support a replacement that gives states broad flexibility and control over markets and Medicaid.

At the close of 2016, about 186,000 Utah residents had signed up for insurance through healthcare.gov, a signature feature of the law, and over the past six years, Utah’s uninsured rate dropped to 10.5 percent, down from 14 percent, Herbert wrote.

“As we work to re-craft healthcare in our country we must be careful not to increase the rate of uninsured, particularly for our most vulnerable citizens,” the letter said.

The governor said he supports a health care overhaul that ensures young people are signing up, because they tend to be healthier and offset the costs of older or sicker people needing insurance.

It should also make the states the main regulator of insurance and give them greater authority over Medicaid.

Obama’s law offered states a chance to expand Medicaid, a state-federal insurance program for the poor, to more people in exchange for the federal government picking up at least 90 percent of the cost.

Utah’s Republican-dominated Legislature blocked the state from taking up the offer, citing worries that the state’s share of the cost would balloon. Herbert pushed for the state to accept the expansion money to sign Utah’s poor up for private insurance plans, but lawmakers rejected it.

In his Jan. 13 letter to McCarthy, the governor attached more detailed recommendations from the state Insurance Department and Department of Health, including suggestions that states be allowed to cap the number of people who can sign up for Medicaid and require them to get a job if they don’t have one. Both proposals were proposed as part of Herbert’s initial Medicaid plan and have been long-rejected under the Obama administration.

Congress has taken first steps to repeal the Affordable Care Act, but the real work will be in the coming months to erase much of the law and replace it.

Republicans have put forward several outlines for a rewrite but have not agreed upon one plan.