After rushing in during the last minutes of a Wednesday evening hearing for the public to weigh in on whether Utah should move forward with a rule that would push thousands off of Medicaid, Angie Garcia leaned over and whispered to her daughter, “Show your fingers.”
The 5-year-old Aramina looked up from the game she was playing on her mom’s phone and wiggled her right hand in the air. Angie, Aramina and the child’s father have a genetic condition called Apert syndrome, which causes bones in the skull, feet and hands to atypically fuse.
“Now she’s able to do that, thankfully, because of Medicaid,” Garcia said of Aramina, who wants to become a veterinarian, “and that will help her write and work.”
Since President Donald Trump took office, Utah has begun the process of asking the federal government for a waiver to implement work and reporting requirements for some Medicaid recipients.
Wednesday was the last in-person public comment session, but the state’s Department of Health and Human Services will accept input online for another week. The dozens who joined the meeting, both at the Salt Lake City office building and remotely, unanimously opposed the proposal.
This is the second time Utah has sought to impose employment as a prerequisite for some low income Utahns to receive free or discounted health coverage — a maneuver aimed at reducing health care spending by the federal and state government.
Under the last Trump administration, in December 2019, the Centers for Medicare and Medicaid Services signed off on Utah adding a condition that some adult recipients work, or seek work. The state pressed pause on the initiative just a few months later in response to the beginning of the COVID-19 pandemic.
In 2021, President Joe Biden’s administration mandated that Utah and other states reverse previously proposed and approved work requirements. Although such rules have been subject to litigation in the past, the U.S. Supreme Court has never ruled on the matter.
To qualify for Medicaid in Utah, a single person must have a salary below $20,820, and a family of four can’t bring in more than $42,768 annually.
(Francisco Kjolseth | The Salt Lake Tribune) The Utah Department of Health and Human Services holds a public hearing in Salt Lake City on a proposal to impose work requirements on Medicaid recipients on Wednesday, May 14, 2025.
Utah’s DHHS initiated the most recent work requirement request, called an 1115 waiver, said Medicaid Director Jennifer Strohecker. “We did it in consultation with the governor’s office and lawmakers.”
Utah is one of 14 states, all Republican-led, to pursue such a waiver since Trump moved back into the White House, according to a tracker compiled by KFF Health News. The Beehive State’s pending action comes amid a push in Congress to establish Medicaid work requirements nationwide.
“If Utah has a proposal and Congress has a proposal, what happens with that? I’ll just say we don’t exactly know the answer to that right now,” Strohecker told Wednesday’s audience before implying that she expects a federal plan would be more strict.
Strohecker promised attendees that her office would review all of the comments and that they would be shared with the national office that approves waivers. State DHHS officials will meet with lawmakers to discuss the proposal next week.
One current lawmaker, Sen. Nate Blouin, D-Millcreek, joined the public comment session, as did two former Republican representatives — Paul Ray, of Clearfield, who is now DHHS’s director of legislative affairs, and Marsha Judkins, of Provo.
“We’ve had a lot of conversations already in the past about barriers that the most vulnerable Utahns have accessing just basic needs,” Judkins said. “And so when I heard about this waiver application, it just kind of broke my heart, and I felt like I needed to come and engage.”
(Francisco Kjolseth | The Salt Lake Tribune) Marcella Patino talks about her family’s hardships and their need for Medacaid as the Utah Department of Health and Human Services holds a public hearing in Salt Lake City on a proposal to impose work requirements on Medicaid recipients on Wednesday, May 14, 2025.
The proposed rule would impact more than 75,000 adults in the state who use Medicaid.
Having one of a handful of characteristics, like being physically or mentally unable to work, can exempt recipients from the work requirement. But advocates for a variety of vulnerable populations say filing the paperwork and providing the documents to qualify for an exemption can be an insurmountable barrier for some.
Among the people who shared their stories with DHHS Wednesday was Marcella Patino, a nail technician whose child has autism. Because she is an independent contractor, and often has to take time away from work to care for her child, Patino told officials she is concerned she won’t be able to meet the potential work requirements.
“It’s already incredibly hard to be a working mom — please don’t make it harder,” Patino said.
Debbe Jones, a grandmother who cares for both her own mother and her grandson, said if anyone in her family loses Medicaid, “One simple surgical or health-related illness will make me homeless.”
(Francisco Kjolseth | The Salt Lake Tribune) Debbe Jones, who worked as a teacher for 34-years and has two family members on Medicaid says “if either one loses coverage, one simple health related illness will make me homeless,” as she attends a public hearing in Salt Lake City on a proposal to impose work requirements on Medicaid recipients on Wednesday, May 14, 2025.
Groups that support Utahns from a variety of vulnerable backgrounds — from those with mental illnesses, disabilities or struggling with addiction, to people experiencing homelessness or with chronic diseases — have coalesced under Protect Medicaid Utah to oppose this and other proposals to cut Medicaid.
Their representatives Wednesday pointed out how they expect the potential rule would slash more than intended from health care, and where they see exemptions fall short.
Matt Slonaker, who heads the Utah Health Policy Project, opened the meeting with a sentiment that was echoed throughout the evening: “Good health is a precondition to work, not the other way around.”
