Suing While Implementing: Utah Officials Meeting With HHS On ‘Daily Basis’ To Implement Reform

Utah is suing the federal government over the constitutionality of health care reform, but like many states in this position, it’s also taking steps to implement the law. In fact, according to Dessert News, the state is moving quickly to establish a health exchange for small businesses:

Starting on Sept. 1, the Beehive state’s first health care exchange for small businesses will officially begin operation. On that same day, the federal version of the Utah Comprehensive Health Insurance Pool, which covers people with high-risk health conditions, will also start offering coverage. […]

In the meantime, the state is set to launch its own health exchange designed for small employers — of two to 50 employees — in which companies will give their workers money they will use to purchase insurance coverage from a wide array of plan options tailored to their specific needs. Exchanges for larger employers will follow in a few weeks.

The tension between states implementing reform on one hand and suing the federal government on the other, is well pronounced in Utah, which has joined Florida’s challenge to the individual mandate, but has also established a special task force to implement the measure.

According to local health advocates on the ground, moderate to conservative Republicans are working diligently to assert local control over how reform is implemented and maximize Utah’s autonomy over the measure — all the while paying lip service to the repeal meme. The state has applied for the rate review grants announced earlier this week and is considering all other funding opportunities. Utah officials are conducting what was described to me as “daily” meetings with HHS officials about implementation, some of which include the governor’s adviser on health reform, John T. Nielsen and Utah Lt. Governor Greg Bell, a moderate Republican.

The tension in the state seems to rest between moderate and conservative Republicans, the latter of which is not too happy about the state’s partial embrace of reform. State health advocates I spoke to warned me that if the November elections bring the hard liners into power, any progress on implementing the measure could be reversed. But the willingness to at least give reform a try is itself surprising.

One Utah involved in state health issues speculated that even the repeal and replace advocates realize that “this is how they have to do reform and it is important to get started and try out some of these ideas.” “I wonder if they’re not thinking well, the only way to prove reforms are wrong, is to give them a good college try,” this person told me.