Senate advances sweeping Medicaid reform to cap cost growth, shift to risk‑based payments

Summary

The Utah Senate voted to advance second substitute Senate Bill 180 after a daylong debate. The sponsor said the bill would cap Medicaid inflationary rate increases to the state general fund growth rate, push providers toward risk‑based payments, require a waiver request from the Department of Health by July 1, and create a dedicated Medicaid rainy‑day fund if savings are achieved.

Senators on Feb. 18 advanced second substitute Senate Bill 180, a broad slate of Medicaid changes the sponsor described as necessary to curb rapidly rising program costs.

Sponsor (identified in‑chamber later as Senator Lundinquest) told the chamber the state's Medicaid spending has roughly doubled as a share of the general fund over the past decade and, if unchanged, could consume an unsustainable share of future budgets. "Medicaid has become the Pac Man of our budget," the sponsor said, arguing the bill is intended to slow growth and protect other priorities.

The measure sets four core policies: a state policy prioritizing risk‑based (capitated) payments over fee‑for‑service; use of evidence‑based measures and risk adjustment; a cap that ties the inflationary component of Medicaid rate growth to the state general‑fund growth rate (so rates can rise only as fast as general‑fund growth); and the creation of a Medicaid‑specific restricted rainy‑day fund to smooth program swings if growth is tamed.…

Senate advances sweeping Medicaid reform to cap cost growth, shift to risk‑based payments

Summary

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