Utah Governor Gary Herbert signed legislation on Monday that replaced a voter-approved Medicaid expansion with a more restrictive initiative.

In November Utah citizens voted for the full expansion of Medicaid through a ballot initiative. With the passage of Herbert’s legislation, Medicaid is only expanded partially, with full expansion contingent on federal action.

The original proposition allowed low-income citizens earning up to 138 percent of the federal poverty level to enroll in Medicaid. Additionally, the state’s cost of the Medicaid expansion was to be covered by an increase in sales tax. While the federal government was to pay 90 percent of the expansion, Utah’s government would only be responsible for 10 percent.

In contrast to the proposed initiative, the bill, SB96, allows for the partial expansion of the state’s Medicaid program to occur on April 1, 2019. Partial expansion refers to limitations on Medicaid expansions as described by the Affordable Care Act (“full” expansion). Instead of the originally proposed 138 percent cap, the new legislation extends Medicaid eligibility up to only 100 percent of the poverty level. Additionally, the legislation expands Utah’s coverage of the cost to 30 percent rather than 10 percent.

Utah must receive federal approval for a partial Medicaid expansion, as the state will still receive funding but effectively cover less of the population. The federal government has yet to approve a partial expansion, denying Arkansas and Massachusetts. If the federal government does not approve, Utah’s legislation allows for the full expansion of Medicaid with additional requirements for enrollees. Such examples are the requirement to work or remain on workplace insurance.