SALT LAKE CITY — Utah's Republican governor announced Thursday he wants to reject a full Medicaid expansion that would enroll more people in the government program, and instead seek federal dollars to cover the poor in private plans.
Gov. Gary Herbert's decision came after months of pushing back an announcement, making him one of the last governors in the country to announce his intentions about expanding Medicaid.
Herbert, like many Republican governors, is opposed to President Barack Obama's health law but has said the state has an obligation to help the poor.
"If the federal government will just block grant us the money, take away the strings and give us maximum flexibility, we will find innovative ways to do things better," Herbert said.
About 60,000 Utah residents are not covered by Medicaid or eligible for federal subsidies to pay for private insurance.
"This flaw, this hole, is not of our own doing," Herbert said. "But I do believe we have a moral obligation to ensure that the poorest Utahans can obtain good, quality health care."
His plan would set up a three-year pilot program that would use money Utah would have received to essentially cover all those who would fall under a full expansion. The grant money would instead help them purchase health insurance in the private market.
Utah officials are anticipating the block of federal money would be about $250 million in the first year and grow after that, said Dr. W. David Patton, the executive director of the state's health department.
All participants would have co-payments. Those with slightly higher incomes would pay up to 2 percent of their monthly incomes to help pay their insurance premiums.
"That's much better than having to do it a one-size-fits-all way out of Washington, D.C.," Herbert said.
The plan would cover the 60,000 falling through the gap, and then some, helping about 111,000 people.
The block-grant path is unusual but shares similarities with plans in other states, such as Arkansas and Iowa, which have received federal approval.
Utah, too, would have to receive a waiver from the federal government.
Mike Fierberg, a regional spokesman for the Centers for Medicare and Medicaid Services, said in a statement Thursday that the agency will consider Utah's request if it's written and presented.
"We can have no comment on the existing proposals, since nothing is final, and as such any comment would be speculative," he said.
Herbert's plan appears to seek unprecedented flexibility, said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, which advocates for low-income people.
Solomon said she needs to see more details about the plan to know if the federal government would be willing to negotiate with Utah, but she said it appears to be a longshot.
"Giving money without any protections is not something that is likely to happen because the federal government has interest in how those funds are spent," Solomon said.