This dashboard includes data on the Medicaid and CHIP populations in Utah, including enrollment levels, delivery of care, and funding/expenditure information. Data included in this dashboard is updated periodically and can change based on retroactive adjustments to enrollment or expenditures (data was last refreshed on 2022-03-15). Information contained in this dashboard includes:
If you would like to request data that is not included in this dashboard, a request can be filed under the Government Records Access and Management Act (GRAMA). The following link has information on how to file this type of request: Utah GRAMA Requests.
Medicaid was established in 1965 by Title XIX of the Social Security Act. Utah implemented its Medicaid program in 1966, which at the time, focused on acute and long term care. Today, Utah Medicaid provides coverage for physical health, behavioral health, and dental services, as well as long term services and supports.
Medicaid operates as a partnership program between the federal and state governments. Currently, the federal government shares financial responsibility by matching state costs with federal dollars. Utah’s Federal Medicaid Assistance Percentages (FMAP) in 2020 was 70% federal and 30% state funding. While certain federal requirements outline whom and what must be covered in each program, states generally have flexibility to tailor and expand their Medicaid program to meet the needs of their population and state budgets.
All individuals who meet the minimum federal Medicaid eligibility requirements are guaranteed coverage. States can expand upon the minimum federal requirements, add optional or special populations to their Medicaid programs or increase the income eligibility limits. For example, all states have expanded Medicaid coverage to children beyond the minimum required under federal law, but not all states have opted to expand Medicaid to adults without dependent children.
Although many people believe Medicaid provides health care services for all low-income people, in Utah, the program actually only covers individuals that fit in one of the designated qualifying groups. There are more than 30 Medicaid aid categories, each with varying eligibility requirements and varying benefits.
Individuals eligible for Medicaid are guaranteed a basic set of benefits covering specific services and settings. States can add to or vary these benefits in terms of the duration, type, amount and scope of services covered. For example, all states have opted to cover prescription drugs, but not every state covers dental services, vision care or comprehensive behavioral health services.
The Medicaid benefits that an individual may receive depend on several different factors, which include:
Differences in benefits include:
States, in general, set the standards or policies for how they deliver services to Medicaid enrollees within the federal framework and requirements. They also choose how to purchase services and distribute payments to providers. The most common methods of payment in Medicaid programs include:
Regardless of the structure, states must ensure sufficient statewide access of services to enrollees.
States can address their priorities by seeking waivers from federal law or choosing certain variations in the Medicaid program. Some examples include:
The Utah Department of Health is designated as Utah’s Single State Agency responsible for making state applications to the federal government for all Medicaid funding and Medicaid-related program initiatives.
Historically, eligibility workers were stationed around the state and applicants would fill out paper applications and mail it in or return it in person. People can still fill out a paper application; however, today they can apply online at medicaid.utah.gov. The Department of Workforce Services performs the eligibility determinations for all of Utah’s medical assistance programs.