Add blog post: Utah HB 15 Medicaid expansion repeal analysis#616
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Add blog post: Utah HB 15 Medicaid expansion repeal analysis#616daphnehanse11 wants to merge 19 commits intomainfrom
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Key findings: - ~117,000 people would lose Medicaid enrollment - ~90,500 (77%) fall into coverage gap with no replacement - ~26,700 (23%) can transition to ACA - Utah saves ~$99M/year, federal saves ~$729M/year net Closes #615 Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
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- Change "protected" to "unaffected" for children's coverage - Remove subjective phrases like "most vulnerable" and "significant tradeoff" - Replace "no replacement/alternative" with factual "not eligible for ACA" Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
- Separate sections for single adult and parent+child households - Individual charts for each household type - More neutral language throughout Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
…tting - Use 500 data points via axes feature instead of manual loop - Format x-axis as dollars like other articles - Medicaid now shows proper cliff behavior Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
- Add Table 1 showing single adult health benefits at select income levels - Add Table 2 showing parent+child health benefits including Child Medicaid/CHIP - Update charts with 500 data points for accurate visualization - Include CHIP in parent+child chart Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
- Extend x-axis to $120k to show full ACA phase-out - Fix child coverage to include CHIP (Medicaid + CHIP combined) - Update table values with correct simulation data - Child transitions from Medicaid ($3,495) to CHIP ($2,827) at higher incomes Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
- Utah has parent/caretaker Medicaid at 46% FPL ($10,200 for 2-person) - Very low-income parents ($8k) retain Medicaid at $6,043 under reform - Coverage gap for parents starts at 46% FPL, not 0% - Updated table to show parent Medicaid fallback scenario Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
PavelMakarchuk
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Jan 28, 2026
app/src/data/posts/articles/utah-hb15-medicaid-expansion-repeal.md
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- Update affected population numbers with 2024 calibration - Add average age breakdown by coverage outcome - Add bill sponsors (Rep. Eliason, Sen. Grover) - Note about sales tax repeal not modeled Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
Keep both Utah HB 15 post and new Rhode Island posts. Update Utah description with new calibration number (94,000). Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
DTrim99
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Jan 29, 2026
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Add figure titles as well
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| Medicaid is a joint federal-state program providing health coverage to low-income individuals. Before the Affordable Care Act (ACA), Medicaid primarily covered specific groups: children, pregnant women, parents with very low incomes, and people with disabilities. Non-disabled, non-elderly adults without children generally could not qualify, regardless of income. | ||
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| The ACA expanded Medicaid eligibility to all adults under 65 with household income at or below 138% of the Federal Poverty Level (FPL). To incentivize states to expand, the federal government initially covered 100% of expansion costs, phasing down to 90% by 2020—significantly more generous than the standard Federal Medical Assistance Percentage (FMAP) of about 70% for traditional Medicaid in Utah. |
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Replace "significantly more generous" with "higher"
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| The ACA expanded Medicaid eligibility to all adults under 65 with household income at or below 138% of the Federal Poverty Level (FPL). To incentivize states to expand, the federal government initially covered 100% of expansion costs, phasing down to 90% by 2020—significantly more generous than the standard Federal Medical Assistance Percentage (FMAP) of about 70% for traditional Medicaid in Utah. | ||
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| HB 15's trigger—repealing expansion if federal matching drops below 85%—reflects concerns that Congress could further reduce the enhanced FMAP, shifting more costs to states. |
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Tie this more to the context of HR 1 and how it affected Medicaid. And clarify that the 85% is not the statutory rate but a new calculation the bill mandates.
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| ### Utah's Medicaid expansion history | ||
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| Utah voters approved Medicaid expansion via [Proposition 3](https://ballotpedia.org/Utah_Proposition_3,_Medicaid_Expansion_Initiative_(2018)) in November 2018. The legislature initially modified the expansion, but full expansion took effect in 2020. Today, approximately 165,000 Utahns are enrolled in expansion Medicaid. |
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In what way did the legislature modify? If too long to explain or it's just tangential, consider removing "the legislature initially modified the expansion".
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| | Income | % FPL | Medicaid (Baseline) | Medicaid (Reform) | ACA PTC (Baseline) | ACA PTC (Reform) | Notes | | ||
| |--------|-------|---------------------|-------------------|-------------------|------------------|-------| | ||
| | $12,000 | 75% | $8,000 | $0 | $0 | $0 | Coverage gap | |
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Some may be confused, as this technically shows that those in the coverage gap are receiving more in PTC than the Medicaid expansion's estimated benefit. Can we add something to clarify?
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| - **23% can transition to ACA**: These individuals earn between 100-138% FPL and can obtain marketplace coverage with premium subsidies. | ||
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| Children are largely unaffected—they remain eligible for Medicaid/CHIP regardless of the expansion repeal. Only adult coverage under the expansion category is affected. |
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"Children's coverage is largely unaffected"
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| Utah's [House Bill 15](https://le.utah.gov/~2026/bills/static/HB0015.html), sponsored by Rep. Steve Eliason (R-Salt Lake County) and Sen. Keith Grover (R-Utah County) in the 2026 legislative session, would repeal the state's Medicaid expansion if federal matching (FMAP) drops below 85%. Currently, the federal government pays 90% of expansion Medicaid costs. This analysis models the scenario where the trigger condition is met and expansion is repealed. | |||
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| HB 15 would also repeal the 0.15% state sales tax that funds Utah's share of expansion Medicaid costs. This analysis does not model the sales tax repeal, as PolicyEngine does not currently simulate sales taxes. | |||
- Replace 'significantly more generous' with 'higher' - Remove tangential legislature modification sentence - Change 'Children are' to 'Children's coverage is' - Move sales tax note to footnote - Add figure titles (Figures 1-4) - Update expansion enrollment to official 72,000 Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
PavelMakarchuk
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Jan 29, 2026
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| Utah's [House Bill 15](https://le.utah.gov/~2026/bills/static/HB0015.html), sponsored by Rep. Steve Eliason (R-Salt Lake County) and Sen. Keith Grover (R-Utah County) in the 2026 legislative session, would repeal the state's Medicaid expansion if federal matching (FMAP) drops below 85%. Currently, the federal government pays 90% of expansion Medicaid costs. This analysis models the scenario where the trigger condition is met and expansion is repealed. | |||
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Lets not use trigger
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| Medicaid is a joint federal-state program providing health coverage to low-income individuals. Before the Affordable Care Act (ACA), Medicaid primarily covered specific groups: children, pregnant women, parents with very low incomes, and people with disabilities. Non-disabled, non-elderly adults without children generally could not qualify, regardless of income. | ||
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| The ACA expanded Medicaid eligibility to all adults under 65 with household income at or below 138% of the Federal Poverty Level (FPL). To incentivize states to expand, the federal government initially covered 100% of expansion costs, phasing down to 90% by 2020—higher than the standard Federal Medical Assistance Percentage (FMAP) of about 70% for traditional Medicaid in Utah. |
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Lets move wording around incentivizing states
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| ### 2027 Federal Poverty Levels | ||
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| This analysis uses projected 2027 FPL values: |
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Briefly explain how we project 2027 FPL
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| ## Understanding the coverage gap | ||
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| The "coverage gap" refers to people who earn too much to qualify for traditional Medicaid but too little to qualify for ACA marketplace subsidies. ACA subsidies only begin at 100% of the Federal Poverty Level (FPL), while Medicaid expansion covers adults up to 138% FPL. If expansion is repealed, those below 100% FPL would no longer qualify for either program. |
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Rephrase
"individuals who's earnings exceed Medicaid but do not reach [] ACA..."
Something along those lines
"ACA subsidies are administered starting at 100% of..."
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| ## Single adult household | ||
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| Consider a single adult in Utah. Under current law, adults earning up to 138% FPL (~$22,500/year) qualify for Medicaid expansion, receiving approximately $8,000 in annual benefits. |
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Do we approximate the medicaid amounts? Can we have specific values from the model?
| **Figure 1: Health benefits for a single adult in Utah by income** | ||
| <iframe src="https://policyengine.github.io/utah-hb15-charts/single-adult.html" width="100%" height="550" frameborder="0"></iframe> | ||
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| ## Single parent with child |
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similar comments as above
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| | Category | Amount | | ||
| |----------|--------| | ||
| | Total Medicaid savings | $988 million | | ||
| | Federal share (90%) | $889 million | | ||
| | State share (10%) | $99 million | | ||
| | Increased ACA costs (federal) | $160 million | | ||
| | **Net federal savings** | **$729 million** | | ||
| | **Net state savings** | **$99 million** | |
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Are all of those revenue generating? If not indicate so
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| - **22% can transition to ACA**: These individuals earn between 100-138% FPL and can obtain marketplace coverage with premium subsidies. | ||
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| Children's coverage is largely unaffected—they remain eligible for Medicaid/CHIP regardless of the expansion repeal. Only adult coverage under the expansion category is affected. |
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Largely unaffected? Explain who is still affected
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| The chart below shows the distribution of affected individuals by household income. Those in lower-income households are more likely to fall into the coverage gap, while those with higher household incomes can transition to ACA coverage. | ||
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| **Figure 3: Affected population by household income** |
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Can we make this by income decile?
| **Figure 4: Affected population by age group** | ||
| <iframe src="https://policyengine.github.io/utah-hb15-charts/age-distribution.html" width="100%" height="500" frameborder="0"></iframe> | ||
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| **Gender**: Women make up 58% of those affected, while men account for 42%. |
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I would remove these breakdown. Not sure how well our gender breakdown data is calibrated. Employment composition can be complex beyond just employment income and household composition feels less relevant and our data tends to favor larger household compositions across states
Co-Authored-By: Claude Opus 4.5 <noreply@anthropic.com>
Updated all aggregate/microsimulation figures to reflect the latest Utah-calibrated dataset results: 84k losing Medicaid (was 121k), 73k in coverage gap (was 94k), 11k gaining ACA (was 27k), $73M state savings (was $99M), $575M net federal savings (was $729M). Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
- Add HR 1 / OBBBA context and clarify 85% is bill's own calculation - Clarify Medicaid $8,000 value comes from PolicyEngine model - Explain single childless adults have no Medicaid pathway under reform - Add note explaining why ACA PTC amounts exceed Medicaid benefit values - Change children's coverage to "largely unaffected" with explanation Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
- Correct HR 1/OBBBA description: does not reduce expansion FMAP from 90%, but work requirements and provider tax restrictions could reduce effective federal support - Reconcile 72k enrollment (2024 actual) with 84k model projection (2027 with population growth and takeup rate) - Fix redundant "Key findings" / "Key results" header - Round demographics table values consistently - Tighten coverage gap definition to avoid repeating FPL thresholds - Tie conclusion back to HR 1 context - Trim "Analytical tools like" phrasing Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
HR 1/OBBBA context is not directly relevant to HB 15's mechanism. Removed enrollment figure that conflicted with model estimate without a confirmed explanation for the difference. Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
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Summary
Adds blog post analyzing Utah HB 15, which would repeal Medicaid expansion if federal matching drops below 85%.
Key findings:
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