Utah Legislature Claims Health Coverage For 400 People Is Better Than Coverage For 258,000

Our guest blogger is Emma Sandoe, a Health Care Researcher at the Center for American Progress Action Fund.

The Utah state legislature has touted its insurance exchange as a successful example of state based reform, and according to Speaker Dave Clark (R), it represents “Utah’s chance to show the federal government that Utah knows what’s best for Utah.” Clark and the Utah state legislature have decided that their version of an exchange is superior to the exchanges in the national health care reform bills, but when looking at the number of individuals covered, this could not be further from the truth.

According to recent Census data, 364,000 people in Utah are currently uninsured. Additionally, according to a recent study from the Urban Institute, as many as 258,000 individuals may be eligible for coverage in the exchange under national health care reform. The remaining individuals would likely be eligible for Medicaid with full Federal funding through 2016.

On the other hand, the health insurance exchange in Utah currently only covers 400 individuals and lacks many consumer protections. Prices within the exchange can be 130 percent more expensive due in large part to a lack of regulation.

A recent bill that has passed the Utah legislature but isn’t yet signed into law does make some improvements to these consumer protections which helps create a more attractive market for consumers and insurers. However, late additions and amendments weakened these reforms. And in trying to improve its broken exchange system, the legislature has borrowed ideas from national health care reform. Now, risk will be calculated over a broader market to avoid adverse selection, Utah will ban insurers from using pre-existing conditions to calculate premium within the exchange, and larger employers would be invited to participate.

Last week, the Utah House passed a bill that would allow the state to opt out of Federal health reform. The state would leave a significant amount of money on the table if it intends to do so. Not only will health reform give states a large increase in Medicaid funding, the legislation gives states additional grants for state funded clinics and an ability to pursue additional coverage programs.