In 2023, Utah’s Legislature compassionately extended the Children’s Health Insurance Plan (CHIP) to cover a limited number of non-citizen legal resident children (SB 217). Currently, 1,300 Utah children receive health care under this provision.
As passed by congressional Republicans, the “big beautiful” budget reconciliation bill seeks to punish those states, including Utah, that have offered health care coverage to any non-citizens. This punishment cuts the Federal Medical Assistance Percentage for matching funds from 90% to 80% for the Medicaid expansion population. This, by itself, would cost Utah $924 million over the next decade.
It gets worse. In 2019, the Utah Legislature passed a “trigger” provision to cancel the entire Medicaid expansion program if the FMAP falls below 90%. This automatically cancels health care for an additional 78,000 Utahns.
Senators Curtis and Lee face an ethical choice. Will they vote to deprive thousands of Utahns their health care just to provide wind-fall tax cuts to the very rich, and modest tax cuts to the bottom 80%? The Utah Legislature now faces their own “Sophie’s choice” of whether to sacrifice the health of 1,300 kids to preserve the health of 78,000 adults. These choices will require new courage.
William Cosgrove, M.D.
Cottonwood Heights