I'm here to talk you into the best of four crappy decisions. —Lt. Gov. Spencer Cox
SALT LAKE CITY — After pitching his plan personally to GOP lawmakers Tuesday, Gov. Gary Herbert said the details of how Medicaid expansion money would be used may have to be sorted out in a special session of the Legislature.
But the governor said he expects "clear direction" before the 2014 Legislature ends March 13 to start negotiations about how the state can use what he says is $258 million available under the Affordable Care Act, also known as Obamacare.
"I would like to have them give me that authorization, that blessing, that 'go get 'em cowboy' kind of an approach and see what we can do back in Washington. I'm very optimistic," Herbert said.
His plan to accept all of the federal money offered for a state-administered program to provide health care coverage for low-income Utahns willing to work is competing with proposals from the House and Senate.
House Speaker Becky Lockhart, R-Provo, is pushing a plan to reject the Medicaid expansion money in favor of spending some $35 million in state funds for limited insurance coverage using existing state programs.
And Sen. Brian Shiozawa, R-Cottonwood Heights, wants to use only a portion of the Medicaid expansion money to cover just those Utahns who would otherwise not receive subsidies under Obamacare.
Neither the House nor Senate GOP caucuses could agree which plan to back Tuesday. Herbert met behind closed doors with the Senate GOP caucus and sent Lt. Gov. Spencer Cox, a former state representative, to the House caucus.
"There's three different proposals out there, and we've got eight days to reconcile them. We will," Herbert told reporters, even though that may only be "a plan to have a plan" with few specifics.
"We won't have everybody happy, you know. But we'll have clear direction that the governor needs to go back to Washington and negotiate a deal," Herbert said. "I'm going to go back, and I'm going to do it."
He said the law requires him to make decisions about Medicaid expansion in conjunction with the Legislature.
"I'm not worried about not having authorization or the ability to go back. I will work with the Legislature," Herbert said.
Cox, who spoke to House Republicans before they closed their caucus, started off by saying the issue had become "fairly toxic" and they all should be able to agree that they hate Obamacare.
"I'm here to talk you into the best of four crappy decisions," Cox said, telling the House Republicans repeatedly the governor is looking for their help. "The governor's plan is not set in stone at all."
House members appeared to have little interest in the argument Cox made that Utah taxpayers are already paying more than $800 million a year toward Obamacare and should get some of that money back.
Rep. Brad Wilson, R-Kaysville, said it would be politically difficult to reverse a program created by the governor's plan.
"It seems to be an irreversible decision," Wilson said, adding that those should be made slowly.
And Rep. Ken Ivory, R-West Jordan, warned the federal funding pledged to the states for Medicaid expansion was not sustainable because of the nation's debt.
"It's really just a classic Ponzi scheme," Ivory said.
Rep. Dean Sanpei, R-Provo, who helped draft the House plan, said it appears the governor is focused only on getting the maximum amount of money from the federal government, not the most flexibility for using it.
Sanpei said after the closed-door debate among House Republicans that he heard nothing from Cox to change his mind.
"The lieutenant governor is a former member of the body. He is well-spoken. But I don't think he was very persuasive," Sanpei said.
He said while there are discussions about combining the various plans, "I'm not very optimistic."
Lockhart, who is seen as a possible challenger to Herbert in the 2016 gubernatorial election, said there is "a wide divide" between her plan and the governor's.
She said the House caucus "is closer to having a position" after their discussion. The speaker said "it's hard to tell at this point" whether lawmakers will be able to settle on a direction before the session ends.
Senate Majority Leader Ralph Okerlund. R-Monroe, said it's "very possible" that lawmakers won't pass a Medicaid bill this session.
"If we work out something better after the session, we can always come back and do a special session," Okerlund said. "But the discussion will continue regardless, and work on it will continue regardless."
The Senate leader said the caucus had a "lively discussion for 45 minutes" after the governor and David Patton, executive director of the Utah Department of Health, spoke about the Healthy Utah plan but reached no conclusions.
"At this point, all the options are open," Okerlund said. "We have confidence the governor will continue to work with us in this process, and I think he left with the confidence that we're going to work with him."
Senate Budget Chairman Lyle Hillyard, R-Logan, said he hasn't seen a bill for the governor's plan or how much it will cost. He said legislation would have to be drafted quickly so lawmakers could consider it before the session ends.
Meantime, both Shiozawa and Sen. Jim Dabakis, D-Salt Lake City, announced a meeting Thursday to hear personal health care stories from a dozen families impacted by the Medicaid decision.
"With many months of spreadsheets, budget talks, reports and studies, it is time to hear from the Utah people most affected by the decision," Shiozawa said.
Contributing: Dennis Romboy