Friday, December 19, 2014


by Paul Gibbs

December 18 was a spectacularly bad day for both compassion and common sense in Utah. In its final meeting for 2014, the Utah Healthcare Reform Taskforce chose to exclude Healthy Utah from their list of recommendations to the legislature for providing health care to people in the coverage gap. The options they did choose don't even accomplish the logical minimum goal of closing the gap. They help only a small percentage who qualify as "medically frail", leaving out tens of thousands of the working poor and throwing away huge amounts of Utah tax dollars. It would easily qualify the members of the committee who voted this way for the bad judgment hall of fame, yet co-chair Sen. Allen Christensen describes it as the "glass half full" approach. I would argue that the glass doesn't count as half full when you started with a full glass and poured out half of it out of it out of ignorance and spite.

Fortunately, this doesn't kill Health Utah. This was only a recommendation made by the task force, and we saw willingness from two Republicans  (Sen. Becky Edwards and Sen. Brian Shiozawa) to fight for what is morally and fiscally responsible. But it's a big setback, especially considering the crucial role Rep. Jim Dunnigan, the new House Majority Leader and co-chair of the taskforce, is expected to play in legislative process. Dunnigan is an insurance agent who is being called an "expert" by the legislature, and many have said they would go by what he supports. He has been working on the issue of healthcare in Utah for 10 years. Well, frankly, I'm not impressed with an "expert" who takes 8 years to work on an issue, gets a workable solution from the federal government, takes 2 more years to watch it get watered down, then chooses to take less money to help fewer people. This is a guy who has used the campaign slogan "Get it done again with Dunnigan"? Up until recently I thought Dunnigan would act as a moderating influence on the more extremist members of the task force. I thought he was essentially reasonable, and he seemed to be headed toward reluctant acceptance of Healthy Utah. I don't know if I was wrong, or if getting the House Majority Leader position made a change for the worse, but if this is the kind of leadership we can expect, he's going to be a crushing disappointment.

The two approaches suggested by the task force would cover between 12 and 20 percent of those below the poverty line, such as those who are mentally ill, addicted, or disabled, or too sick to work. While covering these people is of course necessary, it leaves out the majority in the gap. 66% of those in the gap work and can't get health insurance. Those people are left with no options. How does this accomplish the goal of encouraging "personal responsibility"? The task force is suggesting we punish people for working. This blatantly commits the Medicaid opponent's avowed cardinal sin of "encouraging dependence", because it leaves people no help once they're able to work. And, as suggested by stalwart supporter of the poor Rep. Rebecca Chavez-Houck, we'll be adding to the "medically frail" by preventing those on the edge from getting preventative care.

I pray that you're shocked and outraged by this. I pray that you'll send and email to Rep. Dunnigan telling him how strongly you oppose this decision. I pray that compassion and wisdom will prevail. Because we just took a serious hit, and we need people to stand up, or tens of thousands of Utahns will be left out in the cold, betrayed by their own legislature.


Friday, December 12, 2014


by Paul Gibbs

I believe in self-reliance. Both morally and as a matter of practicality, I don't being overly dependent on others is a good thing. It's not fair to them, and it's not good for you. But any good concept can be distorted. The distortion of the concept of self-reliance is the basis for one of the most common arguments used by opponents of Medicaid, Healthy Utah, or any government program of that nature, that it "promotes dependence". While there is no legitimate proof of or even evidence of this concept, it continues to be treated as if it were established fact by its adherents. And I'll admit there's at least a specious logic to part of it: the idea that once you get past a certain income level, you become ineligible for that kind of assistance, which motivates you not to get ahead. But if one is going go along with that thinking, it's inescapable that Healthy Utah, by eliminating the coverage gap, eliminates that motivation.

Let me explain this as a Q and A

Q: How are people dependent now?

A: Currently, a person who does qualify for Medicaid can lose that coverage by moving just slightly over the limit. It doesn't have to be enough to allow you to afford health insurance, mind you, just enough to go over an arbitrary limit on a piece of paper.

Q: What would Healthy Utah do about tto change that?

A: It would raise the income level required to get people off of coverage.

Q: But won't they just be able to move to move up a little higher, then still be stuck either making less money or giving up their insurance?

A: N
o, because then they can get coverage under the ACA.

Q: The what?

A: Obamacare.

Q: But Obamacare is bad.

A: Well, that's debatable, but love it or hate it's there and it's not going away. Because of Obamacare, when somebody makes too much to qualify for Healthy Utah they become eligible for subsidies that help them pay premiums, so there's no motivation not to move head.

Q:  But then won't they just want to stay where they are and not move off of Obamacare?

A: No, because to lose eligibility for that, it means they make enough to afford health insurance on their own. Healthy Utah completes a bridge that eliminates any need to avoid moving ahead just to keep what you have. It eliminates the motivation to be dependent.

Q: But if we didn't have these programs, people would just want to move ahead in the first place and we wouldn't need programs at all. Isn't that  the way to discourage dependence?

A: Uh . . . No. If that were the case we wouldn't have over 45,000 people in the coverage gap, they'd all have good jobs with good insurance. Motivation doesn't help much when there's no way to get what you need.

Q:  Huh.  But if you're already getting a free ride why move ahead?

A:  It's not a free ride. You pay small premiums, even with Healthy Utah. Besides. Healthy Utah and Obamacare don't buy your groceries, pay your rent or utilities, buy your clothes, your car, gas, or anything like that. It doesn't give you a free ride, it's just a safety net that gets people access to something they can't make it without.

Q:  Then how come I hate it so much?

A: I have no idea.

If anything, Healthy Utah (and yes, the big bad Affordable Care Act) help encourage and provide ways for people to be less dependent. There is a bridge to self -reliance, and right now that bridge is unfinished, with a huge gap in the middle. Let's close the gap and finish the bridge.

Saturday, December 6, 2014


by Paul Gibbs

As a lifelong member and returned missionary of The Church of Jesus Christ of Latter-Day Saints, I was overjoyed by the presence of Presiding Bishop Gary E. Stevenson at the press conference announcing Utah governor Gary Herbert's Healthy Utah plan, and by the following statement issued by the Church:

"We recognize that providing adequate health care to individuals and families throughout Utah is a complex and weighty matter. It deserves the best thinking and efforts from both the public and the private sectors.
"While the economic and political realities are being debated, we hope the discussion and decisions taken in this matter will be consistent with the God-given principles regarding care for the poor and the needy that in the end benefit all of His children. We reaffirm the importance for individuals and families to be as self-sufficient as their particular circumstances allow and recognize that the lack of access to health care can impair a person's ability to provide for self and family.
"We commend public officials for their efforts to grapple with these difficult issues and pray for their success in finding solutions that reflect the highest aspirations of society."
Of course this doesn't constitute an official endorsement of Healthy Utah by the LDS Church, and it would be wholly inappropriate for me, as a member, to present it as such. It's a declaration of the LDS Church's beliefs and standards of caring for those in need, very much in line with the recent General Conference talk by Elder Jeffery R. Holland of the Quorum of the Twelve, in which he charged members to do what they can to help. But, speaking only for myself, I believe that the only plan for closing the coverage gap currently under consideration by the Utah legislators that is consistent with these principles is Healthy Utah. In my opinion, the "Do Nothing' option of rejecting all federal funding (which thankfully Gov. Herbert and House Speaker Greg Hughes consider unacceptable) blatantly violates all of them. The alternative proposals fall short on at least some levels. Let me explain how by running down the principles discussed:
Healthy Utah is a public program which benefits and utilizes the private sector by giving those in the coverage gap access to insurance from the private insurance market.
Healthy Utah benefits the poor by giving them access to insurance coverage, and respects the taxpayer by bringing back to Utah the maximum possible amount of our taxpayer dollars. Alternative proposals fall short of both of these goals, bringing coverage to fewer people and rejecting huge amounts of Utah taxpayer money.
Healthy Utah included reasonable co-pays and premiums which encourage personal responsibility, but do not as people to metaphorically "run faster than he has strength" (The Book of Mormon, Mosiah 4:27). Alternative proposal do not respect circumstances and ask exactly this. By reducing the coverage to only those at 100% of the coverage gap, these proposals force those at 101-138% to pay higher premiums and deductibles, with the only help coming from ACA subsidies that were never intended to be enough for people at this income level. 
This one is obvious: all proposals other than Healthy Utah leave a large number of people without reasonable, affordable access to healthcare. Healthy Utah even helps people to become more self-sufficient through the much discussed Work Effort which helps those who are unemployed or underemployed find employment or gain employable skills.
Again, I wish to stress that the conclusions drawn here are entirely my own. I'm not suggesting the LDS Church endorsed Healthy Utah, or that Mormons are obligated to support it. merely that, fortunately, Healthy Utah fits all of the principles they did endorse. And unfortunately, the other proposals do not.

Friday, December 5, 2014


by Paul Gibbs

Yesterday, Governor Gary Herbert held a press conference to announce the details of the Healthy Utah plan. Gathered with him were local business and religious leaders (including Bishop David Wester of the Catholic Diocese of Salt Lake and Gary E. Stevenson, Presiding Bishop of The Church of Jesus Christ of Latter-Day Saints) showing their support. It's exciting to be at this point, with a workable plan in place, one which makes big compromises to fit the values of Utah's conservative majority while maintaining the core benefits and compassion of Medicaid expansion. In any part of the real world this would be hailed as a win-win situation on all sides. But this isnt the real world, it's politics. And that means some people aren't content to win unless they can see their opponents lose.

Members of Utah's legislature have unveiled their alternate proposals, which still include their visionary "do nothing" plan (in fairness, I am encouraged by the fact that incoming House Speaker Greg Hughes doesn't consider this an option, and House Majority Leader Jim Dunnigan has also indicated his belief that we can consider this off the table). I'm unable to make any logical sense out of the alternate proposals, which still involve taking back less of Utah's tax money and providing coverage to fewer Utahns in need. Again, in any real world scenario these options would be considered lose-lose, but here they serve the entirely ideological and impractical purpose of taking a stand against the federal government even though it hurts us. Nobody would be hailing those who had participated in the Boston Tea Party if they had thrown the Tea overboard then volunteered to pay for it. But that's essentially what is being proposed here. 

For my part, I really don't care about winners or losers or egos or saving face or who gets credit or what message is sent. Healthy Utah is no ideological victory for an Obama supporter like me. When it turns out to be a huge success the very conservatives who have been blocking it will be the ones taking the credit because it comes from a Republican Governor in a red state. And it's no a personal feather in my cap, either. I'm just one of many cogs in the machine of people fighting for this.  Within a month of Healthy Utah passing I predict not much of anybody outside of a few people I worked directly with will remember that Entitled to Life ever existed, and I'm more than fine with that. All I care about is that there are tens of thousands of Utahns who are just as good as anybody struggling to be healthy or stay alive, and every delay makes their situation worse. Talk of "taking the time to do this right" ignores common sense and medical science by pretending people won't get sicker the longer they don't have access to care, and that losing health or lives now won't impact generations to come.  These other so-called plans are not effective, fiscally responsible or very helpful to people in need. Even those who would be eligible for ACA subsidies under the plans that only cover up to 100% of the poverty level can't afford the higher premiums and co-pays required. That's why the ACA didn't put them in that category to begin with.  Figuring people on the edge will be fine is transparently short-sighted and trades the long term good of Utah and its people for short term ideological victory.  It's a perfect example of the sort of "rationing" of which healthcare reform opponents seem to be so afraid.

But the contradictions get even more baffling: in the past Healthy Utah opponents have responded to suggestions that we take the money now and then cut off the program if it doesn't work out with cries that at that point we'd have a moral responsibility to these people (we don't have one now?) and can't do that. Now we're hearing some essentially propose doing this as a planned strategy, with the idea being that we take the 100% federal funding while it's there, then when it's time to scale back to a 90-10 scenario we cut off everybody over 100% of the poverty level. Wow. This idea may be the ultimate triumph of reducing the equation to merely being about money and completely ignoring that, lost in the rhetoric about taxes, are tens of thousands of Utahns who won't make it without our help.




Thursday, November 20, 2014


by Paul Gibbs

If we're to subscribe to the idea that there is such a thing as "Utah Values", it's a no-brainer that nothing is more central to them than families. Even something as divisive as our state's same-sex marriage debate had both sides vehemently arguing their different views about what was good for Utah families.

How then can we ignore the impact delaying Healthy Utah has on Utah families? According to statistics I've taken from the wonderful local organization Voices For Utah Children, 85% of the families in the coverage gap have at least one working parent. While the children can receive coverage through CHIP, their parents can't, and many are not eligible for Medicaid. We're talking about 44,000 Utah families where the parents are uninsured, and at least one of them works. For those who don't work, the most common reason is that they're "taking care of family". Is anybody going to tell me that's "against Utah values"?

The logic is airtight: Parents who are able to take take of their own health will be better able to take care of the needs of their children. By helping these parents do so, we would be helping Utah children, and strengthening Utah families. Whether you're providing for the material needs of a family by working outside the home, or nurturing and taking care of the day to day needs of children at home, being a parent is hard work. Trying to do it while dealing with an illness or physical ailment is considerably more difficult. Trying to do it while dealing with an untreated illness or physical ailment is something I'd prefer not to think about. But we have to think about it. And when we can so clearly do something about it, we have to do that, too.

And Healthy Utah  would also provide help for older adults, including parents and grandparents. Low-income, near senior adults who are not yet eligible for Medicare coverage can get that coverage through Healthy Utah. We have the potential here to help, in some cases, three generations of Utah families. That certainly fits the "Utah Values" I grew up on.

The full details of the Healthy Utah plan will be reported to the Utah Healthcare Reform Task Force on December 4. That will leave a plan the Governor's office and federal government have agreed upon ready to go. All it needs is approval from our legislature. But now incoming House Speaker Greg Hughes is saying Healthy Utah is unlikely to be approved or shot down as is, but will be tweaked and reworked by 6 experts in the GOP caucus. I have to say, I've seen the work of some of these experts and I'm still waiting to be impressed. It's taken them two years to work toward a solution to a problem that already had a solution in place, and now they want to go back to square one? Any changes in Healthy Utah will have to be taken back to the federal government for approval. Utah families can't wait for another lengthy negotiation process. We need Healthy Utah now.


Monday, November 17, 2014


by Paul Gibbs

I get asked a lot of questions about Healthy Utah. Despite the length and intensity of Utah's Medicaid expansion/Healthy Utah debate, a lot of people still don't really know what's going on here.  I've put together some quick answers to basic questions about the issue. Of course you should keep in mind that I'm just a blogger/activist, and you shouldn't take my word as definitive. I strongly suggest checking out other sources such as Utah Health Policy Project or Voices For Utah Children for further information.,

What is the coverage gap?

Essentially, the people who make too much money to qualify for traditional Medicaid but not enough to qualify for assistance through subsidies under the Affordable Care Act (ACA).

What is Medicaid expansion?

In order to allow for those who don't qualify for Medicaid or ACA subsidies, the ACA has a provision which expands Medicaid coverage to include those in that category. The intention was for it to be mandatory, but the same 2012 Supreme Court ruling which upheld the individual mandate determined it was unconstitutional to force states to expand Medicaid. Therefore, it became the decision of individual governors whether or not to accept federal funding for Medicaid expansion. The program allows states to take back their own ACA taxes to pay for Medicaid expansion. Starting in 2013 it would have paid 1100% of the costs for the first 3 years, and never more than 90% after.

Who decides whether we accept the federal money?

The original federal law said it was up to the governors. Gov. Gary Herbert could have made the decision to do so, until in the 2013 legislative session the Utah legislature passed a resolution requiring they sign off on any expansion. While some maintain that Herbert still has the choice to accept expansion on his own, state law makes it clear that he does not, and governors such as Virginia's Terry McAuliffe have failed spectacularly at trying to go around their legislature. At this point, anyone pushing that we have to accept the original Medicaid expansion instead of Healthy Utah is being as much of an ideological obstructionist as the legislators who don't want to accept anything. Getting the original ACA Medicaid expansion past them has considerably less chance than the proverbial snowball in Hell.

So what is Healthy Utah, and how is it different from Medicaid expansion?

Healthy Utah is a plan developed by Gov. Herbert and his administration which will take back the ACA tax money, but instead of expanding traditional Medicaid it will provide subsidies for people in the coverage gap to obtain coverage through the commercial market. It has other provisions Medicaid doesn't, such as co-pays and a voluntary work effort which helps unemployed Healthy Utah patients find work.

Which is better, Medicaid expansion or Healthy Utah?
That depends to a large degree on your political ideology. Liberals tend to prefer Medicaid because it doesn't reauire co-pays or premiums for people who have difficulty affording them and has fewer hoops to jump through. Conservatives tend to see Healthy Utah as an improvement, because it emphasizes "personal responsibility" through the premium co-pays efforts, and benefits the insurance market.

In the most important respects, the two pland accomplish essentially the same things. They both give roughly 111,000 Utahns in need access to healthcare coverage (those who say Healthy Utah would cover fewer people than Medicaid are merely stuck on a different set of numbers. One estimate is based on now, another is based on the the future. It works out the same). While whether those in the gap can afford premiums is a very valid concern, care has been put into keeping the premiums very low, $15 for the first adult in a household and $10 for each additional adult covered (children are covered by CHIP or Medicaid and do not pay premiums).

What are people against this?

There are a variety of reasons given. Some have a degree of legitimacy and others, frankly, are merely ideologically based paranoia.  Arguments include:

It costs Utah money.

Yes, that is true, and of course expenditure of tax payer funds should never be taken lightly. But the simple reality is that Utah can afford this. No less than 90% will always be paid by federal tax money, and the costs won't bankrupt or harm our state. Through wise financial management and prioritizing, we can afford them. Priorities must be established and difficult choices must be made,  and that's what we elect our legislature to do.

The federal government can't be trusted to live up its end of the bargain, and they'll make cuts.

This one is pure politics with no evidence to back it up. The federal government has never made cuts to Medicaid, and the idea of President Obama undercutting his signature legislation by making those cuts is laughably absurd.

It will breed dependence.

Again, pure politics. As popular as this argument is with conservatives, there has never been real evidence to support it. The majority of people who receive Medicaid only do so for about 1 year, which shoots down that argument quite nicely. And once people make too much for Healthy Utah they become eligible  ACA subsidies. When they make too much for that, they no longer need help. If anything, closing the gap reduces dependence by eliminating the incentive and creating a clear path away from dependency.

We shouldn't be paying for able bodied  people who don't work.

This one is just an absurd distortion of what Healthy Utah does. According to studies by the University of Utah, 66% of those is the gap already work, and 85% of families in the gap include at least one working adult. 15% are disabled or otherwise unable to work. Are there people who could be working but aren't? Probably. But they clearly constitute such a small minority that denying access to healthcare to tens of thousands of others just to avoid helping them can't be seen as reasonable or moral.

Take a look at some of the so-called "able-bodied people who don't work" in my film Entitled to Life.

Sometimes access to healthcare can kill people.

Yes, somebody actually said this. Rep. Mike Kennedy made the argument in reference to Doctor errors which in some cases result in death. While this certainly occurs, this has to be the most specious argument I've ever heard. By this logic nobody should be getting health care (only poor people are subject to Doctor errors?), and we should stop wearing seat belts, looking while crossing the street, exercising, etc. One of my most beloved family members died because of a Doctor error. At no point did I ever think "maybe that means I'm safer not going to a hospital" because of that, because it's simply a ridiculous thought.

There no evidence this will save lives.

Well, a study by Harvard University estimates that roughly 316 people in Utah per year will die due to lack of care without the program. I think that's pretty good evidence.

There are other options for people who need help (free clinics, etc).

Perhaps (in some cases) for basic care, but not specialty care such as MRIs and CT scans, or more advanced care.  And representatives of Utah's charity care network have spoken up in favor of Healthy Utah, saying charity care can't do this on its own.

This is a job for churches and charities.

Providing coverage for what is estimated to range from 45 to 77,000 people? The charity argument is covered above. Simple logic says churches can't cover this. For example, I belong to the LDS Church, which is well known for looking after its members. And I received a great deal of help from charity fundraising for my kidney transplant. That still would have left me paying about $145,000 out of pocket, which I couldn't possibly have done. The Archie Bunker

Employers will drop thousands of people from their coverage plans because they can just put them on Healthy Utah.

This is another piece of speculation that isn't backed up by evidence. The conservative Sutherland Institute and former Utah State legislator Dan Lilljenquist love to make this claim, and their projected numbers keep changing dramatically. But it hasn't happened yet in any of the 28 states (or Washington D.C.) which have expanded Medicaid, and ADP, America's largest payroll company, has stated that none of its thousands of clients has any plans to drop healthcare coverage. Not to mention that the ACA includes substantial financial penalties to employers who do this.

We can just expand to cover up to 100% of the poverty line, not the 130% Healthy Utah requires.

Yes, we can, but it's a bad idea. We'd get substantially less of our own tax money back and a lot of people struggling to stay just barely above poverty level would be without affordable insurance.

The federal government is behaving like a schoolyard bully, forcing Utah to do things its way.

When you consider the polls which show that an overwhelming majority of Utahns support Healthy Utah or would choose Medicaid expansion over doing nothing, our legislature looks like the bullies.

The President is a Democrat, and I don't like him.

Most opponents aren't actually saying this, but it's what their objections rare really about. Okay, it's true, but is that really a good reason to throw away tax money and deny people access to healthcare?

So, there's basic rundown of the debate. Again, it's not exhaustive or authoritative, and I encourage you to read further.

Watch the An America Plea Healthy Utah Music Video

Friday, November 14, 2014


by Paul Gibbs

People have been asking me why a Florida-based outside group like the Foundation For Government Accountability would bother getting involved in the Health Utah discussion. How does it effect them? The simple answer is it doesn't. Sure, they're claiming they have a stake in this because Florida is paying ACA taxes, but if extremist groups like the FGA hadn't stalled Medicaid expansion in Florida, they'd be getting their tax money back for their own expansion. The fact that their state is throwing money away does not give them a stake in how Utah spends its tax payer money. That's a patently absurd argument.

The truth is, Utah isn't unique. The FGA has run ads attacking Medicaid expansion efforts in Indiana, Arkansas, Maine, and other states, using the same erroneous  points, stock photos and scare tactics. They haven't bothered to learn a single detail about Healthy Utah, or how it differs from traditional Medicaid expansion. And I don't think they care. The people of Utah matter so little to them that they keep ignoring my challenge that they meet with people in Utah's coverage gap and see how it effects them. And now they want Governor Herbert, who has important work to gaining the support of the legislature, to waste time debating them? We don't need to convince them, because this has nothing to do with them. Seriously, are we so short on stubborn, misinformed extremists in Utah that we need to bring some in from out of state? I'm here to tell you that is definitely not the case.

If our legislature wants to be true to their own stated goal of staying true to Utah values instead of letting outsiders tell us what to do, they need to ignore the FGA and listen to the people of Utah instead.

NEW VIDEO SEGMENT: Entitled to Life: Utah Values

Follow me on Twitter @entitled2life

Wednesday, November 12, 2014


by Paul Gibbs

On November 11, 2014, the Deseret News  ran an article called a Florida Group Targets Healthy Utah Medicaid Expansion Alternative, about the the Florida based Foundation For Government Accountability's campaign. I have no issue with article, which fairly reported a newsworthy story  and gave the good people at Utah Health Policy Project a chance to offer a rebuttal. But I have a big problem with the the things FGA says in the article, which quotes them as telling Gov. Herbert not to bring "D.C. values" to Utah, and charging that Healthy Utah puts "able-bodied people" on government assistance. 

What do these people know about "Utah values"? They  haven't been to Utah and have done nothing to learn about the actual people involved in this. I have lived in Utah since i was 1 year old, and as an activist and as a citizen I have spent a lot of time learning about and being with these people, in Utah and in other states. So called "able-bodied" people like:

Who is in a wheelchair because of a neuro-degenerative condition caused by a car accident, and yet still runs her own small business, and goes to college on a scholarship and is about to start offering tutoring services to help keep up her cognitive function.

Who works 3 jops  are working 3 jobs while struggling with multiple types of cancer and trying to raise children.

Who  spent a lifetime working and serving his country as a Marine in Vietnam. and then couldn''t get coverage for his wife spouse when she had a stroke.

A Flordia woman who suffers from lupus and kidney failure, and many other issues.

A North Carolina woman who lost her insurance and suffers from cancer.

Who has two children and lost her job as CEO of a company because of illness.

And another gentleman I go to church with (he hasn't done any media and I don't feel comfortable using his name without him giving anyone permission to put his story out there) who worked as a security guard, but lost that job due to suffering from liver failure. He can't work at all now and has been bankrupted by medical bills. 

These are all people who are in or effected by the coverage gap. And they are just seven of many examples  They are not "able-bodied" people looking for a handout. In all my searching and experience which has taken me across the country I haven't run into anybody like that who is looking for help from Healthy Utah or Medicaid expansion. Do they exist? Probably. Are they the majority? No. And that's not just my experience or my emotions talking, it's the facts/ 

 I've studied the numbers and research, and learned froma  study by the University of Utah that 66% of the people in the gap already work, and another 15% are disabled or otherwise unable to work. For groups like the FGA or the Sutherland Institute this to claim some sort of moral high ground while denying the most basic needs of human beings who are suffering is evil. I realize that's a harsh word, and I don't use it lightly. I'm not saying these are mustache twirling villains who are tying women to railroad tracks. Evil doesn't work that way in the real world. Most of the time, evil takes the form of selfish concerns overcoming basic decency and empathy. And sometimes it take the form of putting loyalty to ideology ahead of clear evidence of suffering people in need. And this most definitely qualifies as such a situation.

If you want the real facts, go to a legitimate organization like Utah Health Policy Project, or even a nobody like me who isn't an expert and doesn't work for a "think tank" but actually thinks experience and facts matter and bothers to accumulate them. And who is willing to listen to and consider things which challenge my own ideas. For example: I adamantly opposed Healthy Utah at first, because it wasn't the straight up Medicaid expansion I was fighting for, and because it came from a Governor and didn't (and still don't) like. But I listened and learned the facts, and became convinced that it's the best option with a chance of passing.

When I went to Florida to fight for their expansion, I met with actually people who are effected by this and learned about what they're going through. I have publicly challenged the FGA to make the journey in reverse, and come from Florida to Utah. Will they do it? I doubt it. 
The FGA cares nothing about Utah, and they aren't experts in anything, they're just ideologues who want to promote an ideology and agenda no matter who it hurts.

Watch the new video segment: Entitled to Life: UTAH VALUES

Friday, November 7, 2014


by Paul Gibbs

The 2014 mid term election wasn't good for anybody who believes in health care as a human right, or really even anyone who believes in human rights as a concept. Let's look at the ups and downs.


Most of the strongest Healthy Utah or Medicaid expansion advocates in our legislature were re-elected. Rebecca Chavez-Houck, Jim Dabakis and Brian King easily cruised to victory. All Democratic incumbents in the state legislature won, and they are joined by the return of Republican supporters like Peter Knudson and Craig Hall. We also gained a new Republican supporter in Raymond Ward of Bountiful. I know Dr. Ward and I expect him to fight as hard for this as any Democrat.

We also have a new Speaker of the House, Greg Hughes, who has the huge virtue of not being Becky Lockhart. Hughes hasn't come out directly in support of Healthy Utah, but it's reasonable to be optimistic that he'll at least be more reasonable than his predecessor. In his words, "We’re really going to drill down on [Medicaid] with the guiding principle being that we do right by our constituents."

 It remains to be seen exactly what Hughes means by that, or what his approach will be. He vows to work with new Majority Leader Jim Dunnigan (an insurance executive), and 4 physicians in the legislature to solve the problem. Dunnigan has is hardly one of our biggest supporters, and the physicians could range from the eminently reasonable Sen. Brian Shiozawa to Rep. Mike "Sometimes healthcare kills people" Kennedy. And if he's planning on supporting alternate solutions to Healthy Utah, that could involve going back to square one in negotiations with the federal government.

We also, of course, saw a lot of our stronger opponents (including Kennedy) re-elected. And the national Republican majority in both houses essentially guarantees more bone-headed and harmful attempts at repealing the ACA. Might our legislature use this as an excuse to delay again?  While the Republicans don't have a big enough majority to make an outright repeal of the ACA likely, any progress on healthcare over the next two years will be a gargantuan task, and that includes Medicaid expansion and variations thereof. We're extremely lucky that negotiations over Healthy Utah are complete, because those states who aren't that far along are in huge trouble. And, sadly, Utah contributed to the added majority by sending Tea Party extremist Mia Love to congress. Ouch.


Local voter turnout was rather low, only 24%. And our opponents had a much better election than we did. This really speaks to something I've been saying for a while: liberal apathy is as big a threat as conservative extremism. We could have made an impact just by having a half-decent turnout, but we couldn't be bothered.

To be honest, this week has been my lowest point with this cause. I'm scared about where we'll go from here. I'm beyond devastated.


Every single supporter has to step up. Clicking "like" on a Facebook status doesn't make you a supporter, and it certainly doesn't make you an activist. We need you writing emails, going to events, everything you can do. No excuses. It's all on the line. We can still do this, but EVERY SINGLE PERSON who supports this has to act in some way.

Email Hughes and Dunnigan. Tell them you supporter Healthy Utah, not any alternate plan that covers fewer people. Because if we don't fight this with all we have, it's over.

Greg Hughes: 
Jim Dunnigan:

Monday, November 3, 2014


Paul Gibbs

Most people who read this blog are probably aware that I have an identical twin brother, Patrick.  Some will know that Patrick and I were both born with serious medical problems. By the time we were 5 years old, I had 9 major surgeries, and Patrick had 17. Obviously this placed a huge financial burden on my parents, even with ths insurance they had through my Dad's employment. Family was only able to do so much. Our church was only able or willing to do so much. An attempt to get help from charity failed when the money raised to help us was embezzled. It was a near impossible situation, and when it reached the point where Patrick was in serious danger of dying, some suggested my parents just accept that there was nothing they could do, and that after all, that still left one of us alive. Of course no parent would accept that, and ours didn't. The debt caused by all of these medical bills is the reason my Mother died poor 5 years ago.

Had my parents chosen to exercise the sort of "fiscal responsibility" that far right members of our legislature are advocating, they would have just let Patrick die. I realize that's an inflammatory analogy, and Healthy Utah opponents would argue that the two things are not comparable. They would say one falls under personal responsibility, and one doesn't. And I would reply that's a self-serving load of crap.  We as a society do have a responsibility to each other.  It is not morally acceptable to let people suffer or die because they're not out problem. Especially when there so clearly is something we can do about it. As LDS apostle Elder Jeffrey R. Holland so eloquently put it, "I may not be my brother's keeper, but I am my brother's brother."

In no way is it fiscally responsible to to turn down $258 million of our own tax money, or the 3,000 healthcare sector
jobs Healthy Utah will bring to our state. Yes, there will be costs to Utah beyond that. But they won't bankrupt or harm our state. Through wise financial management and prioritizing, we can afford them.  And if we choose not to accept that responsibility, we're not choosing freedom or personal responsibility or anything lofty or noble like that. The only thing we're choosing is to apathetically shrug and say "It's not my problem." The rest is empty rhetoric and rationalization.

On of the legislature's most staunch opponents of Healthy Utah responded to those trying to appeal to his Christian values that Jesus said as much about justice as He did about mercy. Ignoring the fact that he and I apparently have been taught very different version of the scriptures despite belonging to the same church, there's the simple fact that it just doesn't apply to this situation in any logical fashion. It is not justice for people to suffer or die from treatable illnesses just because they are poor. That's not a consequence of their actions, it's simply an unfortunate circumstance. Justice and mercy both demand that we help those who cannot help themselves, and study after study after study has shown it's a matter of cannot not will not, so that kind of flat-earth denial is not a reasonable argument.

After months of negotiation, Healthy Utah is ready to go at our upcoming general legislative session. Any "alternative plan" by members of our legislature (which would almost certainly cover fewer people) would take us back to square one in negotiations with the federal government, and would make people who need healthcare now go without it. And, because of the supreme court decision, this comes down to our state exercising its freedom to make a choice, through our elected representatives. While we have the right to make either choice, there is still a right choice and a wrong choice. We can choose both just and mercy, or we can choose to walk away and let others deal with it. But to pretend those are not the only two choices is absurd and wrong. We've put off our responsibility long enough.

Thursday, October 30, 2014


by Paul Gibbs

The Foundation for Government Accountability's anti-Healthy Utah add campaign says that the proposed program "Undermines Utah values". Come again? Caring for our fellow human beings is against Utah values? Making use of our own tax dollars is against Utah values? Of how about this one: keeping families together is against Utah values? Take a look at the latest Entitled to Life video segment and see what I mean.

Tuesday, October 28, 2014


by Paul Gibbs

I spent the last weekend in Florida, where I shot the second of the two Entitled to Life documentaries commissioned me to make for other states. Perhaps our most compelling and heartbreaking interview was with Terinda Furman, a woman in Naples who suffers from a debilitating case of lupus that gives her extreme sensitivity to sunlight. Terinda is a go-getter, a very hard working and motivated woman who has had to learn to live with a myriad of conditions (related to the lupus and otherwise) which render her unable to work. She has tried over and over again. Even taking tickets in a movie theater is beyond her physical abilities. Yet she was dropped from traditional Medicaid over a year ago, and now she and her partner Liz are forced scrimp and find any desperate way they can just to get Terinda her medication, let alone doctor visits. In one afternoon I came to love Terinda and Liz, and it's horrible to see what they're going through.

Upon touching down for a layover  in Denver, I checked my email and discovered that a fellow activist had sent me a link to a new website called, attacking Gov. Gary Herbert's imminent Medicaid expansion alternative, tossing around the word "Obamacare" as many times as possible, and throwing out the same old spurious and disproven horror stories about the effects of expansion. I assumed it came from the Sutherland Institute ("Our ignorance can beat up your knowledge"), but it turns out that it's from another right-wing "think tank" some of our more conservative legislator like to reference, the Foundation for Government Accountability (a group so prominent and respected that Wikipedia is considering deleting the entry on them because it isn't meet "general notability guidelines"). And guess where this "think tank" is located? That's right, Naples, Florida. So why is a group in one of the states most hardly hit by politicians stubborn ideological refusal to expand Medicaid (so much so that they needed a struggling filmmaker from Taylorsville, Utah to come across the country and help them fight for it) meddling in Utah politics? It's one thing for Sutherland to keep attacking this, they're local. But Florida think tanks and Forbes magazine? All desperatey flinging the same disproven points at us again? Why is defeating Healthy Utah suddenly a cause celebre of the disciples of Ebenezer Scrooge nationwide? The answer is funny, frightening, and simple: they're scared.

Healthy Utah is the biggest modification of Medicaid expansion allowed to any state so far. It demonstrates not only that the federal government is willing to negotiate and make serious compromises to make Medicaid expansion happen in states that need it, but that expanding within conservative principles is possible. It shows that a right wing governor can work together with the Obama administration to craft a compromise that makes both sides happy, and they can do it for the least politically acceptable of reasons: it's the right thing to do and people need it. This is a disaster for groups like the Foundation For Government accountability (people promoting letting human beings die to satisfy they're political ideology are talking abut "accountability?), whose whole purpose for existing is to promote the current gridlock that says conservatives and liberals must be mortal enemies, that all forms of government welfare cause every ill from dependence to bubonic plague, that if we allow this to happen then by thunder within a year's time dogs will be cats and vice versa. The worst enemy of hysteria is truth, and Healthy Utah is becoming a powerful truth that not only gives tens of thousands of people access to healthcare that can save their lives or quality of life, but shows we don't have to be at war with each other.

 I'm reminded of the film Star Trek VI: The Undiscovered Country (everything comes back to a movie with me, and very often it's Star Trek), wherein peace between the United Federation of Planets and the Klingon Empire is imminent, and those who cannot accept the idea of peace between them commit desperate acts of sabotage to keep them as enemies. But of course, it's a movie, so people (and aliens) of goodwill on both sides work together for the common good and the dastardly plot is foiled. Well, what's happening here isn't a movie, but I can't escape the similarities. Those who don't want see left and right work together and create a compromise that works for both AND helps the people are throwing everything they can at Healthy Utah now that it's so close to happening. Will we let that fear defeat us? Or is this worth fighting for? Especially when we're so close to winning? I think we all know the answer.

Friday, October 24, 2014


by Paul Gibbs

With Gov. Gary Herbert's announcement that negotiations with the federal government are essentially complete and there will be no special session, we now know that Healthy Utah will be on the table in the 2015 general legislative session. And we have word that members of the healthcare reform task force are planning to propose an alternative plan which would only cover a fraction of what Healthy Utah would. Realistically, full ACA Medicaid expansion isn't on the table. There is a better chance of Dwayne Johnson winning an Oscar than there is of the full expansion getting the approval of our legislature. To put it the only way I can, that sucks. But that's the way it is. The choice isn't between Healthy Utah and the best, it's between Healthy Utah and the worst.

What we're hearing some of the legislators want to do is present a plan that covers only the "medically frail", which is a small fraction of those in the gap. The legislature is right in thinking that these are the people most in need. They're wrong in thinking this will be an adequate solution. This ignores that many are unable to even get diagnosed as medically frail without coverage to see a doctor. It ignores the fact that that keeping people from getting preventative care will just cause more people to become medical frail. And it ignores those who work but and can't afford coverage but don't fall into the medically frail category. I give the legislators credit for agreeing the medically frail need coverage. It shows more compassion than I've sometimes given them credit for. But it's not enough, and it isn't likely to accomplish much in terms of keeping costs down, especially because it will mean getting less federal funding, or none at all.

Here's where we come in: the process of the waiver for Healthy Utah requires a 30 Day "Public Comment Period". I've been relentlessly pushing everyone to contact legislators since March, but during this 30 day period we have to go nuts with it. It goes without saying that I plan to take a very active role in this, but I'll say it anyway. I'll be launching a new element of the Entitled to Life campaign aimed at demonstrating the support of as wide a variety of average Utahns as possible. I'm going to need absolutely anyone who is willing to help me with that (though I won't be asking much of you).  We need to make enough noise that even the Sutherland Institute can't pretend we don't want this. If we make the legislature feel enough pressure, they WILL pass this. This will be our time to make a difference in the lives and health of tens of thousands of people, and we cannot pass it up or let it get away. There's too much at stake. Simple actions and just a tiny bit of courage will be enough.

Monday, October 20, 2014


by Paul Gibbs

According to an estimate by the Deseret News ,roughly 100 Utahns gathered at the state capitol on Saturday, October 18 for the Healthy Utah Vigil. I tried to get my own count at one point but was interupted, so I'll gladly accept theres. Like any event connected with the Healthy Utah/Medicaid expansion cause, it was a highly emotional one.

 The vigil came at the end of a rough week, where both the Sutherland Institute ("Dedicated to preserving 1952 since 1995") and Forbes magazine ran pieces attacking Healthy Utah. The piece I wrote rebutting Sutherland's ludicrous assertion that Healthy Utah discourages marriage is already the mostly widely read of my blog posts. I haven't written one addressing the Forbes piece because, frankly, it's all in my previous writings. They had nothing new to say, just sort of a greatest hits of fallacious arguments against the program. After these attacks, I wasn't sure I was emotionally ready for the vigil. Especially because I'd already gotten some criticism from people on my side who objected to individual aspects of the vigil. But that's okay. You can't get involved with politics and expect not to get any opposition, and that includes opposition from the people on your side.

But the vigil itself was exactly the mornful yet life affirming experience I had envisioned it being. Those in attendence represented a diverse cross-section of Utahns: Democrats, Republicans, Mormons, Catholics, Atheists, Unitarian Universalists, various races and orientations. What we had in that we're Utahns, and that we wants to help those among us who are most vulnerable.

The speakers shared poignant, heartbreaking and inspiring messages. Dr. David Sundwall brought home the message that this isn't a partisan issue by pointing out that he's "a card carrying Republican." He even had the courage to defend one of the staunchest opponents of any form of expansion, Sen. Allen Christensen as "a good man", while disagreeing with him on the issue and pointing out that he's seen.first hand that charity care (which Christensen insists is enough to solve the problem) can't do it alone. This was a difficult and thought-provoking part of the evening for me:  while my first impressions of Christensen were of a friendly and affable guy, his harsh words and refusal to listen have made me come to think of him almost as a comic book supervillain. It's probably good for me to be reminded that, while I strongly believe the ideas and actions of out opponents are immoral, they aren't necessarily bad people, just people being mislead by some very bad ideas.

Arielle Spanville of USARA (Utah Support Advocates for Recovery Awareness) spoke on behalf of some the most commonly marginalized people in the gap, those who suffer from mental illnesses or substance abuse issues. As she pointed out, "it's easier to get heroin in Salt Lake and Utah Counties than to get access to health care.:

The other two speakers were from the coverage gap: Stacy Davis-Stanford spoke about the difficulty of being disabled but not being able to afford to get the diagnosis which would make her qualify for disability coverage, and Melanie Soules, who has managed to get coverage, spoke of how Healthy Utah would have allowed her to get coverage much sooner and lessen the permanent effects of the illness she has now overcome. Both speeches were heartfelt and brought me to tears.

We also premiered a music video about those who are suffering and the need for Healthy Utah:  , "An American Plea".

Two days after the vigil, I have mixed feelings. It was a wonderful. moving, life affirming event. It gave us a chance to mourn and to express hope. But things haven't changed yet. I'm tired of being thanked when I feel like I haven't done anything. I don't know if I've even changed one person's mind. I hope that the spirit of what we did on Saturday will carry over to the legislature in January, and compassion will finally win out. I hope more people will be moved to action to make it happen.

Friday, October 17, 2014


by Paul Gibbs

Sometimes I have a hard time coming up with new angles to address the issue of Medicaid expansion/Healthy Utah, and have difficulty updating this blog because of it. That's why I'm grateful for the Sutherland Institute (motto: "Facts? We don't need no stinking facts."). Every time they lose traction on their previous specious arguments against accepting the federal funds, they dig down deep and come up with something even less genuine that will play to conservative fears. This time (because they're still working on an explanation for how Healthy Utah would spread Ebola) they're trying to protect that favorite battleground of Utah conservatives, marriage.

The argument made is really just a variation of the old "dependence" argument made by hard core conservatives against any form of government sponsored help for the poor. They're saying now that Medicaid expansion (or Healthy Utah, which is the only real option currently under consideration) will cause men to delay getting married because they'll be afraid of losing their eligibility. This is absurd for a number of obvious reasons: being married won't exclude people from Healthy Utah eligibility. And if their income level rises high enough from marriage that they no longer qualify for Healthy Utah, but don't get insurance from either spouse's employment, they will almost certainly be eligible for subsidies under the Affordable Care Act. That's how it works, though I wouldn't expect Sutherland to know that. Their previous criticisms of the ACA clearly demonstrate a total lack of understanding of the law they hate so much.

My wife and I got engaged on December 26, 2011. We were married on June 26, 2013. During this time, people would whisper about "the longest engagement ever" and wonder if we were ever actually going to get married. We wanted to. We never questioned that. But with my income added to hers (at a temp job which lasted well over a year and offered no benefits), I would no longer qualify for Medicaid, and while our two incomes together would pay rent on a small apartment, they wouldn't pay for the monthly supply of anti-rejection medications needed for my transplanted kidney. I'm not saying it wouldn't pay for both, mind you. I'm saying it wouldn't even pay for JUST MY PILLS, which cost the same per month as a two bedroom apartment in L.A. (and here I'm only counting the most expensive of the three types of  anti-rejection meds I take, to say nothing at all of the other meds I take to deal with the side effects of the anti-rejection meds). We looked for more lucrative employment for me, even though I was still suffering through a particularly difficult period of medication side effects and other issues that would have made full-time work very hard on me. When I lost out on getting a job that would have made it possible for us to get married in the summer of 2012 we were devastated. It was like dealing with a death in the family. During all this time, Healthy Utah would have been a godsend. With it's eligibility levels allowing incomes well above what traditional Medicaid does (which is the whole reason for expansion), it would have allowed us to get married, keep working, and get to the point where we had our own private insurance. Eventually, we refused to put it off any longer, and we got married, having no idea what we were going to do. As difficult as it became when Becky was laid off from her job shortly after our marriage began, the fact that it made our combined income so low probably saved my kidney. We both kept searching for full time work, and eventually she found it, including an insurance plan which covers my meds. Once again I was extremely fortunate in a way most people aren't. But if Healthy Utah had been in place, we would have been married within six months or less. We might already have the child we so badly want. And we certainly wouldn't have stopped looking for work, because Healthy Utah wouldn't pay our rent or feed or clothe us or anything else. We would have worked to support ourselves and our children, because we would have been able to do so without dealing with jumping through the endless hoops, delays and obstacles associated with being sick and uninsured.

I'm not saying my experience is universal. But it has a lot more to do with reality than anything you'll find in the Sutherland Institute's latest diatribe .  As crazy as this might sound to them, helping Utah families helps encourage Utahns to have families.

Monday, October 13, 2014


This Saturday, October 18th at 7pm, Utahns will gather at the Utah State Capitol to show their support for efforts to increase low-income Utahns’ access to healthcare coverage. Currently, there are 45,000 low-income Utahns who earn too much money or don’t otherwise qualify for Medicaid, but don’t earn enough to qualify for subsidized insurance on

Utah has been studying the issue for over two years. We have seen Utahns die because they didn’t receive the healthcare access they needed.  Every year we don’t expand Medicaid, an average of 200 Utahns will lose their lives. Utah’s Governor has a plan that will increase access to healthcare coverage with Utah-based solutions. We are not only gathering to mourn the loss of lives, but to celebrate the lives that can be saved by implementing the Governor’s Healthy Utah Plan.

Schedule for the Vigil:
·         7-minute version of the film Entitled to Life will be shown
·         Opening prayer from a Catholic clergyman
·         Dr. David Sundwall will offer his thoughts on why Utah should close the gap
·         Hear from Utahns in the Medicaid coverage gap, Stacy Davis-Stanford and Melanie Soules
·         Other religious leaders as confirmed
·         Closing prayer

WHAT: Healthy Utah Candlelight Vigil
WHERE: Utah State Capitol | South Steps

WHEN: Saturday | October 18th | 7:00-8:30pm