Committee backs Medicaid amendments to preserve targeted programs and allow legislative review after federal changes

The House Revenue and Taxation Committee unanimously favorably recommended the second substitute to HB15, a bill intended to prepare Utah for expected federal changes in HR1 and to preserve critical components of targeted adult Medicaid (TAM).

Chair Lisonbee (sponsor) said the bill does not expand Medicaid. Instead, it adjusts the state’s trigger law timeline so the legislature would have at least one session to review significant federal changes before a statutory sunset would take effect. The sponsor emphasized the bill’s purpose as proactive: "the principle of act or be acted upon."

Committee members asked whether the substitute changes income eligibility thresholds. The sponsor and advocates, including Stephanie Burdick of the Protect Medicaid Coalition, clarified that the bill reorganizes and clarifies existing code and waiver language but does not change income eligibility (Medicaid expansion remains tied to 133% of the federal poverty level). The sponsor also explained that prior waiver language referencing 95% was a legacy formulation and that the substitute brings code into alignment with CMS‑approved waivers.

Several witnesses spoke in support. Patrick Fleming (Policy Review Committee, Utah Behavioral Health Commission) and Adam Cohen (Odyssey House) said HB15 protects services for vulnerable populations, especially people exiting jail, those experiencing chronic homelessness, and individuals with substance‑use disorders. Justine Case of the Rare Disease Advisory Council urged preservation of waivers that families rely on for high‑need children.

Representative Cofer moved to favorably recommend the second substitute; the committee approved the motion by voice vote. The sponsor said a subsequent fiscal note for the substituted bill was expected to be released that day and that the sponsors expected a fiscal impact of $0; the committee noted follow‑up on fiscal documentation would occur if needed.