POLITICS

These Citizen Activists Fought Hard to Expand Health Care. Then Their Lawmakers Rebuked Them.

Utahns took Medicaid expansion into their own hands at the ballot box last year. The GOP legislature took it right back.

It’s hard to get a ballot initiative in front of voters in Utah. Proponents of changing state law via direct action by voters must get petitions signed by the equivalent of 10 percent of the number of people who voted in the most recent federal election, or more than 100,000 people, and they must meet that threshold in 26 of 29 of the big, sprawling state’s Senate districts.

Yet organizers and citizen activists in Utah managed to pull off that feat last year for three propositions: legalizing medical marijuana, establishing an independent board to draw legislative district lines and expanding Medicaid to low-income adults. Voters approved all three on Election Day, an impressive showing in a state not known for a progressive populace.

The Republican politicians who run Utah were not about to let this stand

The majority-GOP state legislature and Gov. Gary Herbert (R) have already scaled back the marijuana and Medicaid initiatives, and changes to the redistricting policy are under consideration.

And now, Utah legislators are considering changing the law to make it even harder to get voter initiatives on the ballot and implemented when they pass. At least some in the Utah legislature don’t want a repeat of what happened in November.

Utah’s elected officials operated entirely within the law in doing these things, as the legislature is permitted to modify voter-approved initiatives. But that’s of little consolation to the everyday Utahns who devoted many hours going door to door collecting signatures, talking about the issues with colleagues, family members, friends and neighbors, and working to get out the vote.

Americans often speak of a disconnect they feel between them and their elected leaders, a sense that the people in power don’t care what they want and don’t listen. Lawmakers swiftly undoing their hard work reinforces the sense of disaffection that pervades American politics, and that sentiment is clear in Utah.

“I was very angry, because the people have spoken. And these people are elected to represent us, not because we think they’re any smarter and they need to do it their way,” said Fridolyn Hicks, 63, of Cottonwood Heights, outside Salt Lake City. “That is just unconscionable, for someone to think, ‘I know better than my constituents,’” she said.

Hicks, a retired mental health care professional, was one of the many volunteers who carried clipboards around the state collecting signatures and campaigned for a chance to extend health coverage to an estimated 150,000 low-income Utahns. She worked with other activists in the Utah Civic Action Network, or UCAN, a Facebook group that has grown into a community of citizen activists.

Scott Bell, a retired mining engineer and co-founder of UCAN, was never active in politics until the 2016 presidential election, when the former Republican volunteered for Democrat Hillary Clinton’s campaign. Last year, UCAN organized signature-collectors for five ballot initiatives, including the three that went before voters and passed.

Members of the group gathered about 28,500 signatures, said Bell, 62, of West Jordan, which is outside Salt Lake City. Bell also ran for a state House of Representatives seat last year, losing to the Republican incumbent 54 percent to 46 percent.

Months of hard work culminated in the election night victories, only for Bell to watch as the legislature cast them aside.

“I am infuriated and insulted,” he said. Voters spoke clearly on these ballot initiatives, he said, but  “the legislators still turned around and said, ‘No, no, no. We know what’s best for you.’”

Bonnie Bowman, a supporter of a voter-approved measure to fully expand Medicaid, at a protest at the Utah Capitol in Salt Lak
Bonnie Bowman, a supporter of a voter-approved measure to fully expand Medicaid, at a protest at the Utah Capitol in Salt Lake City on Jan. 28.

A main purpose of ballot initiatives and referenda is to allow citizens to take action on policies when elected officials won’t. In the case of Medicaid expansion in Utah, Herbert and the legislature had debated the question since the U.S. Supreme Court ruled in 2012 that states could opt out of the Medicaid expansion, which is part of the Affordable Care Act.

All but 14 states have adopted Medicaid expansion since then, including via ballot initiatives in Idaho, Nebraska and Utah last year, and in Maine in 2017.

Under the Affordable Care Act, Medicaid is available to anyone earning up to 133 percent of the federal poverty level, which is about $16,000 a year for a single person and $33,000 for a family of four, in states that take up the policy. The federal government provides 90 percent of the funding. Utah’s proposition included an increase in the sales tax from 4.7 percent to 4.85 percent to finance the state’s share.

“I felt like the legislature, many of them were never going to judge Medicaid expansion on its own merits or faults,” said Paul Gibbs, 44, of West Valley City, who campaigned for Proposition 3 to expand Medicaid. “They were going to judge it based on their partisan or ideological prejudices.”

Gibbs had more confidence in the people of Utah. “I believed that they would listen, they would learn, and that they would act with compassion and intelligence,” he said. “And in my opinion, they did.”

Following a special session in December to weaken the medical marijuana policy voters approved, the Utah legislature started in on Medicaid expansion when lawmakers reconvened in January.

After abandoning an early version of legislation to amend Proposition 3 that might have resulted in no Medicaid expansion at all, the legislature passed and Herbert signed a final measure limiting the expansion to people with incomes below poverty ― about $12,000 for an individual and $25,000 for a family of four. The replacement for Proposition 3 also includes other limitations on benefits, including a work requirement.

Legislators were quoted in news reports saying they had to act because voters didn’t understand what they approved.

“Let’s stop pretending like this is the will of the people,” state Sen. Jacob Anderegg (R) said in January, according to The Salt Lake Tribune, “because the will of the people was based on not all the facts.”

The activists and organizers HuffPost interviewed remained pleased that their efforts resulted in even a partial expansion of Medicaid, which is expected to provide health coverage to about 90,000 people. And they’re convinced that even this result wouldn’t have occurred without Proposition 3.

And, if Herbert and the GOP legislature thought undercutting these ballot initiatives would dissuade supporters from continuing to fight, they seem to have miscalculated. The first sign may have been the hundreds of people who protested at the state Capitol in Salt Lake City at the start of the legislative session this year after lawmakers began formulating their plans to modify Proposition 3.

For Gibbs, the fight is personal. He credits government health care programs with saving his life a decade ago. The filmmaker was born with a kidney disorder that continued into adulthood despite multiple surgeries. When he learned he needed a kidney transplant at age 34, he had no health insurance.

But he qualified for both Medicaid and Medicare, that latter of which is available to people with kidney failure regardless of age. Friends raised about $10,000 ― and one even donated him his kidney ― but there was no way he could have covered the $160,000 procedure out of pocket.  

Gibbs was well aware of how burdensome health care costs can be, as his parents died in debt from surgeries he and his brother had as children. The Medicaid expansion debate got Gibbs involved in Utah politics for the first time.

“Everybody has an absolute right to stay alive, and poverty should not be an obstacle,” Gibbs said. “I wouldn’t have survived without that help from Medicare and Medicaid. I didn’t think I deserved anything that anybody else didn’t deserve.”

Karina Andelin Brown, 46, was one of the activists who originally submitted Proposition 3 in November 2017, kicking off the campaign. A stay-at-home parent in Logan, Brown was a lifelong Republican before becoming active in her local Democratic Party in 2016. She ran a long-shot candidacy for the state House of Representatives seat in her northeastern Utah district last year, but lost to the GOP incumbent 76 percent to 24 percent.

Brown is upset the legislature didn’t allow Proposition 3 to take effect as voters approved, but said she’s still glad at least some more Utahns will have access to health care.  

“It shows that Utahns are more progressive than our elected officials,” Brown said. “I hope that Utahns are motivated and take that frustration they feel, or happiness, or excitement, or whatever they feel from this whole process and take it into the 2020 elections.”

HuffPost

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Health Care Protests At U.S. Capitol
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