If there are two things which kind of define my personality these days, it's that I'm a healthcare activist and a film geek. As such, a lot of my attention is divided between two different approaching events: the unveiling of the new Gang of Six Medicaid expansion alternative plan and likely subsequent vote in a special legislative session, and the release of Star Wars: The Force Awakens. I mention these two unrelated topics because the people behind them are approaching them in surprisingly similar ways: under a protective layer of secrecy, revealing only as much as they have to every now and then. This approach works for Star Wars. J.J. Abrams knows the anticipation and surprise are half the fun, and keeping us hooked with a little bit of information but leaving the big questions unanswered will help us enjoy his film all the more. But with the Gang of Six, I'm concerned that this approach leads to serious and negative consequences.
Because the gang of Six is playing their cards so close to the chest, it's very easy for opponents to jump in and fill in the information gaps. The problem is that the groups who are doing this organizations like the Koch brother's Americans For Prosperity, the Sutherland Institute. the Foundation For Government Accountability, and the Libertas Institute, or pundits or former legislators who share their ideological outlook. These groups have two things in common: they're all very far to the right, and they all vehemently oppose any Utah healthcare expansion which accepts federal funding. Let make sure I'm being clear on the emphasis of the word any. They don't oppose the Gang of Six plan because they're afraid it won't do what Healthy Utah or straight up expansion of traditional Medicaid will. They oppose it because they're afraid it will. This leads to a situation most of us would never see coming: proponents of expansion, including Democrats and other progressives, are buying into Koch brothers propaganda, because for once the people they're bad mouthing are Republicans.
As I said before, a big part of the responsibility for this comes from the frustrating lack of information coming from the Gang of Six. It's understandable that expansion proponents are wary of a plan coming from a group which includes such notable Healthy Utah opponents as House Speaker Greg Hughes and House Majority Leader Jim Dunnigan. And the lack of inclusion of any Democrats, liberal, moderate or otherwise, in any part of the negotiation, also invites distrust. It's not a matter of partisan pride or ego, it;s just not a good approach to public policy. It wasn't a good approach nationally when a Democratic super majority pushed through the Affordable Care Act unilaterally, and it's not a good approach for Utah now. I've chosen my comparison here very deliberately: I may not be the biggest fan of the way the ACA was passed, but while the ACA is imperfect, it's a huge improvement on the way things used to be, and I support the law. What I'm hearing from non-Koch related sources on the Gang of Six plan tells me that, while imperfect, it also offers a great deal of good.
Here are a few genuine facts we know about the new plan:
-It covers up to 138% of federal poverty level the same as Healthy Utah or expansion of traditional Medicaid.
-It returns the maximum available amount of Utah tax payer money.
-It will reimburse providers and hospitals at private market rates, which are higher than traditional Medicaid rates, which is beneficial to hospitals and providers.
-The coverage benefits would be required to be Medicaid equivalent (Silver Level)
-There would be no new caps, no coverage gaps, or reductions in benefits as long as the federal funding remains intact.
If this doesn't sound much like the horrible scenario we're hearing from opponents, it's because it isn't. The doomsday scenarios are at best based on wild speculation, and it's important to reiterate that they're coming from those who want to stop any kind of expansion, not from people looking for the best way to do it to benefit the poor. As frustrated as I frequently get with Utah's legislature and other leaders, these ultra ideological groups are the ones we should be seeing as inherently and eternally untrustworthy. I don't believe that we should or can afford to stubbornly and blindly stick to the idea that a plan supported by Greg Hughes and Jim Dunnigan has to be a bad one. But I believe we can and should inherently question any "information" which comes from these groups.
In the coming weeks, as details of the new plan are unveiled first behind closed doors to the House GOP Caucus, and then publicly to the Healthcare Reform Task Force, we should learn a lot more about it. It's very possible that we'll learn things we don't like. But I strongly suspect that we'll also learn things we do. Based on what we already know, I'm prepared to support and even fight for the new plan. Because, as I've said again and again, it's absurd for us to keep clinging to the notion that defeating a more conservative friendly compromise is going to get us straight up Medicaid expansion (or even Healthy Utah at this point). At best it keeps stretching out and slowing down the process while legislators come up with new plans that will keep moving us further away from what we want, not closer to it.
I understand if some expansion supporters aren't as eager to support the new plan as I am. But don't jump to opposing it. That's exactly what the Koch brothers and like-minded groups want us to do, and we can't let them control this debate.