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Senate advances Medicaid ACO measure but holds transmittal pending fiscal note
Summary
Senators approved first substitute SB 98 on Medicaid accountable‑care organizations and passed a linked joint rules resolution; senators flagged and clarified a fiscal note of about $2 million and agreed to hold the resolution with the bill so they move together to the House.
SALT LAKE CITY — The Utah Senate passed the first substitute of SB 98, a legislative package addressing Medicaid Accountable Care Organizations (ACOs) and tying any ACO compensation increases to state budget growth.
Senator Adams, sponsor of SB 98, described the bill as a fiscal-control measure: ACO compensation would track state‑budget growth so increases in ACO payments correspond to the legislature’s budget trajectory.
On the floor Senator Hilliard noted a fiscal note did not appear on the bill text available to some senators and asked about cost estimates. Senator Adams acknowledged that a fiscal note exists and said it was about $2,000,000. The clerk and leadership clarified that the Senate would not transmit the bill to the House until the fiscal-note paperwork was in order; the senators also passed SJR 4 to tie the legislative budgeting process to SB 98 so the two move together.
The floor record shows the first substitute of SB 98 received 28 yeas, 0 nays, 1 absent. The Senate voted SJR 4 as well and directed that the two items be held together for transmittal so the fiscal implications travel with the bill.
Supporters said the approach aligns ACO growth with state budget capacity; questions on the floor focused on ensuring cost estimates and fiscal transparency were in the committee record before the bill leaves the Senate.
Next steps: Leaders instructed that SB 98 and the tied SJR 4 be sent together once the fiscal-note materials are complete.
