Amanda is married with two children. A supervisor of a driver's license office and an administrative law judge, she has recently bought her first home! But if you had met Amanda a couple years ago, you would have hardly recognized her!

Pregnant with her first child and living at the poverty level, Amanda found herself in an abusive relationship that often left her homeless. But for one year, between 2004 and 2005, Amanda was able to rely on our state's health care safety net - Medicaid.

Had her healthcare needs not been covered, she most likely would have not been able to carry her son to term. Her high risk pregnancy required her to see a neonatologist every month and undergo a fetal non-stress test weekly. Even so, her son was born with gastroschisis, a serious congenital defect in which the intestines develop outside the fetal abdomen. He stayed at Primary Children's Hospital for the first 5 months of life.

"Without my son in my life I never would have applied myself and straightened my life out. And without Medicaid I would have let the doctor terminate the pregnancy because I had no means to pay for it. I am grateful to have had Medicaid to get me through that vulnerable time of my life," says Amanda. "It made all the difference."

The Legislature should take great care as they look to shave dollars from Medicaid. Medicaid delivers quality, medically necessary care at the right place for all payers - including the taxpayer. It is also a powerful economic driver for our state. Before making cuts, the Legislature should:

• Maximize cost containment measured within Medicaid, such as introducing "never event" policies that prevent Medicaid from paying for preventable mistakes; step up the state's Medicaid fraud prevention measures.
• Prevent cost-shifting by considering new revenue sources. Keeping Medicaid whole will prevent expensive cost-shifting to small businesses and other purchasers of private insurance. To avoid this, Utah should increase the tabacco tax rate up to $2 and use the state's $414 million Rainy Day Fund to maintain Medicaid eligibility levels and provider rates.
• Reform the health care payment and devlivery system- starting with Medicaid.