Could We Take the Entire Medicaid Program Away from the Feds?

   I wonder about the wisdom of taking Medicaid in Utah away from the federal government, entirely, and administering it at the state level.
   Gov. Gary Herbert has suggesting taking the federal funds and administering them through private companies in a program he calls Healthy Utah. I've wondered if that is worth it, as taking federal funds and giving them to private enterprise puts the mask of private enterprise on what really remains a government program. It is possible such an effort might also add a level of administration, since private administrators and government administrators would both being involved.
   But, the significant thing is that the Obama Administration is willing to let Utah do such a program. The feds are willing to let Utah have its own program. It makes me wonder how much Medicaid autonomy we might be given. Currently, Medicaid in Utah is administered by the Utah State Health Department, with the federal funds coming to that agency. California is allowed to slap its own name on its Medicaid program, calling it Medi-Cal.
   You'll remember Utah House Speaker Becky Lockhart wanted to reject the federal program and offer a state-funded program for some of those who need Medicaid expansion if they are to have any coverage. Well, could we take that a step further? Could we suggest that while we like Becky Lockhart's idea, we want all of Medicaid, not just part of it? And -- here's the kicker -- could we suggest that while we will pay for the whole thing, it does mean we want federal taxation for Medicaid in Utah to be discontinued?
   Figure out how much of the tax dollar is going to our Medicaid, and no longer collect it from taxpayers in this state.
   I don't know whether the laws governing Medicaid allow for such an arrangement. Nor am I silly enough not to realize the taxes for a state program are going to be significantly higher than if the federal government does the collecting. You have got to be suspicious that much of the federal funding is coming not from taxes, but from borrowing and from increasing the national debt.
   Which is the whole reason for moving the whole kit and kaboodle to the state. The state's constitution requires a balanced budget. So, we have protection against deficit spending.
   It would be better yet if private enterprise were willing to take the whole kit and kaboodle. But, I'm venturing that if Gov. Herbert's proposed program allows them to take federal funds, it might mean private enterprise knows they cannot insure everyone while still turning a profit.