By: Catherine McKee
Executive Summary
In comments to the Department of Health and Human Services, the National Health Law Program urges HHS to reject Utah’s proposed project, which would impose a number of unlawful conditions on coverage and access to care. Utah requested a number of restrictions, including: capping enrollment in the expansion population; imposing work requirements; charging premiums (and terminating coverage and imposing a lockout penalty for failure to pay); charging an amount higher than otherwise permitted for non-emergency use of the emergency room; eliminating hospital presumptive eligibility; imposing a lockout penalty for an “intentional program violation;” eliminating EPSDT for people ages 19 and 20; cutting services for parents; and ignoring various managed care protections. The comments explain why the proposed project does not comply with the requirements of § 1115 of the Social Security Act.
