Medicaid Adult Expansion

By June 30, 2018, the Utah Department of Health will request authorization from the federal government to make several
significant changes to the Utah Medicaid program. Three bills from the 2018 Legislative Session require these changes:

• House Bill 472 “Medicaid Expansion Revisions”
• House Bill 435 “Medicaid Dental Benefits”
• House Bill 12 “Family Planning Services Amendments”

Specifically, the Department is requesting the authority to implement Medicaid eligibility for adults, aged 19–64 who earn
up to 95 percent of the Federal Poverty Level (FPL), or $12,140 per year. Projected enrollment for this program expansion is approximately 90,000 individuals. In addition, the amendment adds a work requirement for this adult group, requires adults to purchase employer-sponsored insurance (if available), and requests the ability to close program enrollment if projected costs are higher than available funding.

The Department is also requesting authority to:

• Add dental benefits for Targeted Adult Medicaid members who are receiving substance use disorder (SUD) treatment (approximately 3,000 individuals)
• Implement Medicaid eligibility for adults not otherwise eligible for Medicaid to provide them with family planning services (approximately 11,200 individuals)
• Provide specific services to at-risk Medicaid eligible children and youth in state custody or those at risk of being placed in state custody, and their families (approximately 720 children/youth)

More information about these waiver amendment requests, the public comment process, and the full waiver application is available on the Medicaid website: https://medicaid.utah.gov/1115-waiver.