Skip to Main Content

Families USA State Comment Letter on Utah Per Capita Cap 1115 Application

By Emmett Ruff,


Families USA submitted this letter in response to Utah’s request for comments on its application for a new Section 1115 Medicaid waiver seeking a “per capita cap” – or a limit on federal spending – on major portions of its Medicaid program.

Multiple elements of Utah’s proposal are both legally problematic and poor policy choices for the state. We support state decisions to accept enhanced federal matching funds to expand Medicaid coverage, however, to receive those added funds, states must comply with the requirements of the Medicaid program as defined by federal Medicaid law. Much of Utah’s request under this proposed waiver fails to meet those requirements.

As noted in a Families USA analysis, the proposed waiver would be a bad deal for Utah taxpayers and government. If approved by the Trump administration, it would set a new precedent that could have catastrophic effects for state budgets and Medicaid programs in the future. Approval and implementation of this waiver request will increase the state’s share of Medicaid costs and will result in thousands of low-income people losing health care coverage.

Families USA recommends that Utah should not submit its request to CMS. Read the rest of our comment here.