October 2014 Calendar

>>Thursday, October 23, 2014

Health Reform Task Force

Location: Utah State Capitol; Room #30 House Building (map)

Time: 9am-12pm

Agenda (html)

Agenda highlights:

We expect an important update about the Healthy Utah negotiations with HHS, concurrent with Gov. Herbert’s monthly KUED news conference.

Health Care Roundtable

>>A bi-weekly (1^st and 3^rd Wednesdays) gathering of advocates, stakeholders, and others interested in health policy and legislation in Utah, especially Medicaid Expansion

>>Wednesday, November 5, 2014

Organization: Health Care Roundtable

Location: Utah Cancer Society (941 E 3300 S, SLC UT 84106) (map)

Time: 1:15pm-2:15pm

Contact:  RyLee Curtis (email)

>>Wednesday, November 19, 2014

Organization: Health Care Roundtable

Location: Utah Capitol – Senate (West) Building, Olmsted Room (map)

Time: 1:15pm-2:15pm

Contact:  RyLee Curtis (email)

Grassroots Outreach and Canvassing

Closing the Coverage Gap Campaign Events

Utah Communities for Healthcare Coverage

Get involved here

ACA Timeline

November 5, 2014

Deadline for final determination of Utah insurers selling policies on healthcare.gov and Avenue H.

November 15, 2014

Open enrollment begins on Healthcare.gov for 2015 insurance plans

November 21, 2014

Take Care Utah Enrollment Open House

Sorenson Unity Center (1383 S 900 W, Salt Lake City, UT 84104)

December 15, 2014

Deadline for renewing or enrolling in new insurance that starts on 1/1/15

UHPP Events

Thursday, November 6, 2014

UHPP’s Fall Fundraiser

Time: 6pm-9pm

Location: Caputo’s Deli (314 W 300 S Salt Lake City, UT)

RSVP: Website is under development

More Information: Contact Laura Coyne via email, or phone, at 801-433-2299.

Friday, November 21, 2014

Take Care Utah Enrollment Open House

Take Care Utah (web)

Time: 1pm-7pm

Location: Sorenson Unity Center (1383 S 900 W, Salt Lake City, UT 84104)

Free enrollment assistance, health screenings, plus movies and face painting for kids

 Map: https://goo.gl/maps/V2LOR

Tuesday, December 2, 2014

UHPP’s Fall Conference: Is It Working? Taking the Pulse on Health Reform in Utah

Time: 8am-4pm

Location: Utah Cultural Celebration Center (1355 3100 S, West Valley City, UT 84119)

RSVP (link)

Upcoming Health Reform 101 Presentations

In 2013-14 UHPP has made over 150 educational presentations about health reform to more than 6,600 people. To schedule a presentation for your group or organization, email Jason Stevenson via email, or call 801-433-2299 x7

Thursday, November 6, 2014

Health Reform 101: Building Owners and Managers Assoc. of Utah

Time: 8am-9:30am

Location: IHC Doty Educational Center (5121 South Cottonwood Street, Murray, UT)

Auto-Renewal Made Simple

84,601 Utahns signed up for new health insurance on healthcare.gov during the first open enrollment period in 2014. That means lots of Utahns have questions about how to renew or switch their insurance for 2015. They might also be wondering how their premium subsidies (defined) might change.

Any Utahn with health insurance purchased from healthcare.gov should take 30 minutes to follow the steps outlined in this article. If you don’t, you could end up paying too much for health insurance, or keeping a plan that doesn’t work for you anymore.

UHPP recommends that you schedule a “tune up” for your ACA insurance before the December 15th deadline to finalize your insurance for 2015.

In fact, we recommend you do it well before December 15th because everyone and their grandmother will be logging into healthcare.gov in mid-December. Trust us. You don’t want to be there.  

If you’re unsure how to proceed, or the prospect of going to healthcare.gov makes you want to binge-watch Toddlers & Tiaras, we’ve got you covered.

Contact the trained enrollment experts at Take Care Utah (TCU, www.takecareutah.org) to schedule a one-on-one ‘tune-up’ for your health insurance options. TCU has more than 60 “navigators” and “certified application counselors” standing by to provide free, in-person advice and answers. If you don’t have Internet access, you can find the nearest TCU assistor by calling 2-1-1. 1.

But if you want to “tune up” your own insurance policy, start by following the three “R” words listed below: Review, Renew, and Re-determine.

Review: Log into healthcare.gov and update your personal information, income projections, and plan choices. Make sure your current health plan is still your best option. Remember: Even if you keep the same plan, your level of premium subsidies could be different in 2015 (see below)

Renew: Re-enroll in the same health insurance, or switch to a new plan that suits you better. If yo

ur current policy is being discontinued (a rarity), your insurer will switch you to a similar plan. If you do nothing, insurers will automatically renew your existing coverage. But that could cause problems if your family size, income, or premium subsidies changed. Note: Your premium subsidies could change even if your details stay the same.

Redetermine: Authorize healthcare.gov and the IRS (yes, that IRS) to re-calculate and approve your premium subsidies (also called advanced premium tax credits or APTCs) and cost-sharing assistance. Note: Healthcare.gov is sending notices via postal mail to currently-enrolled consumers to inform them of the redetermination process.

Shifts in Premium Subsidies
Keep in mind that your premium subsidies, the financial assistance that reduces your monthly insurance premiums, could change even if your income, family size, and insurance plan remain the same in 2015.

How can that happen?

Although all six Utah insurance companies that sold plans on last year’s marketplace are returning for 2015, many of their plans have changed. And more importantly, the benchmark plans (ie. the second-lowest Silver Plan in each geographic area) used to calculate premium subsidies have changed for every geography in Utah (link, “#5. Health Insurance Plan Rates-2015”)

This means that even if your insurance plan, income, and family size remain the same in 2015, the amount of your premium could change based on shifts elsewhere in the marketplace.

For more explanation on how benchmark plans influence subsidies, check out this easy-to-read article, and this detailed study.

About Take Care Utah
Visit www.takecareutah.org
Call 2-1-1
Take Care Utah helps people find and understand their new options for affordable healthcare coverage by connecting them with trained enrollment specialists in their communities and neighborhoods. 

Confused about Health Reform?

Since January 2013, UHPP has made over 150 “Health Reform 101” presentations to 6,600 people across the state—including the Utah Dept. of Health, Workers Compensation Fund, the Univ. of Utah, BYU Law School, medical offices, and public libraries. 

We specialize in a jargon-free, localized, and “just the facts” approach to the crucial health reform issues facing Utah. Plus, we are constantly updating our content to reflect new information about Utah’s marketplace and insurance options in 2015.

Copied below is summary of what we talk about:

Presentation Title: Heath Reform 101: The Road Ahead for Healthcare Reform in Utah
 
Description: An in-depth look at how national health reform impacts Utah in 2015 and beyond
 
Topics Discussed:

• How does health care reform affect my family and my job?
• How do Utah’s insurance marketplace work?
• What will the marketplace look like in 2015?
• What do I need to know when filing my 2014 taxes?
• Who will be eligible for premium subsidies?
• How is the ACA paid for?
• Where can I shop for new health insurance?

The Utah Health Policy Project (UHPP) is a nonpartisan, nonprofit organization advancing sustainable healthcare solutions for underserved Utahns through better access, education, and public policy.

To schedule your own Health Reform 101 presentation, or learn more - contact: 

Jason Stevenson
Education and Communications Director
Utah Health Policy Project
w. 801-433-2299 x.7 
email

Ask a Navigator

Q: Will healthcare.gov work better this year?  

Sincerely,
Glitched Out

A: So good to see you again. And thank you for asking such an important question. It’s October and another open enrollment begins on Noviembre 15. And although I would rather discuss my new carne asada tamales recipe, I wanted to tell you about some new things happening with healthcare.gov.

As you might now, healthcare.gov is the website where Utahns can review and

shop for health insurance. And it is the only website where you can receive premium subsidies to reduce your monthly insurance payments (en Español). Plus, if you want your insurance to start or renew on January 1, 2015, you need to sign up on the marketplace by December 15, 2014. And remember that this year’s open enrollment is only three months long. It ends on February 15th!

Last year healthcare.gov didn’t work well at first. It was like sticky cheese that stuck in your throat. And the problems lasted for weeks! But luckily they fixed it, and over 84,601 Utahns signed up for coverage.

This year we know that healthcare.gov will work much better from the beginning. Yes, there will be glitches. But they will be pequeño compared to the grande problems last year.

Here are the Top Ten Things we know about the new healthcare.gov:

1) You can start to review the new 2015 plans and premiums starting on November 10… ….but you can’t start shopping until November 15.

2) Screening questions were added to the beginning to determine if you would use the traditional application or a new streamlined application which is only 16 pages long and takes less time to complete. We expect about 70% of applicants to use the streamlined application, and 30% to use the traditional more detailed one. Hopefully you are one of the lucky ones!

3) The entire website has been overhauled with these changes:

• Backward navigation, which means if you made a mistake on a previous page, you can click back a screen back to fix your whoopsie without starting all over
• Fewer screens to navigate overall
• Optimization for mobile users, so youngsters can shop for insurance on their fancy smartphones
• Shorter, smoother, simpler user experience, so that old granny’s like me can navigate it, too

4) There will be at least 15 more insurance plans to choose among along the Wasatch Front. Choice is good, si?

5) If you don’t understand a word or phrase like “deductible” or “out of pocket maximum,” you can place your mouse over it on the screen and the definition will appear in a tiny little window. So cute!

6) We expect some insurance rates to go up, some to go down—and the overall average increase to be 5% to 7%

7) Utah will continue to enjoy some of the lowest insurance premiums in the nation. Hooray for healthy living!

8) Fewer website glitches means faster applications and more time for crocheting!

9) You still need an email account to sign up, but you will have more options for healthcare.gov to contact you in case you prefer the old-fashioned phone or postal service.

10) The website is blue. Very blue. Everywhere is blue. Did you know that blue is my favorite color?

If you have any other questions or need assistance, my navigator amigos at Take Care Utah (Alex, Julie, Luis, Marissa and Felipe) are standing by to help with your application online.
Give us a call at 801-433-2299, or find an enrollment expert in your area by going to www.takecareutah.org, or calling 2-1-1.
 
Until next time!

Take Care Utah
www.takecareutah.org
Call 2-1-1
Take Care Utah helps people find and understand their new options for affordable healthcare coverage by connecting them with trained enrollment specialists in their communities and neighborhoods. 

Is the ACA Working?

Utah Health Policy Project (UHPP) is excited to announce our upcoming annual conference "Is It Working? Taking the Pulse on Health Reform in Utah."  

Join our team and your colleagues from Utah and across the nation for an interactive discussion about year one of Affordable Care Act (ACA) implementation.

Reserve your seat now: (RSVP)

Tentative Topic Sessions:

Is It Working? A National Perspective
This year’s conference is all about checking the vital signs of health reform and diagnosing its future. Many questions exist about the ACA: Which states are succeeding? What’s different about the 2015 marketplaces? Will the ACA marketplaces attract new customers the second time around?

Life After Enrollment: A Panel Discussion with Utah's ACA Kitchen Cabinet
Our ACA Kitchen Cabinet share their experiences—from scheduling doctor’s appointments to adding newborns to their insurance policies—guiding us on how to improve the delivery-side of health reform.

The Value Added by Navigators: What Do They Bring to the Table?
A panel of navigators, certified application counselors, and brokers will discuss their experiences and the value that a navigator brings to Utah's health system.

Covering the Gap--The Utah Way
A discussion about Utah’s path toward finding a solution to fill the Medicaid expansion coverage gap. We'll be answering questions about where we started two years ago, what it’s taken to get to where we are now, and what the path looks like going forward.

For sponsorship opportunities, please contact Laura Coyne at email, or phone, at 801-433-2299.

Event Details:
Date: Tuesday, December 2, 2014
Time: 8:30am to 4:00pm (MST)
Location: Utah Cultural Celebration Center (1355 3100 S, West Valley City, UT 84119)
Reserve your seat now: (RSVP) 

It's Time to Party

UHPP's Annual Fundraiser is fast approaching.

Join us at Tony Caputo’s Market and Deli (314 W. 300 S., SLC) on Thursday, November 6, 2014 from 6pm to 9pm.

Come be a part of the fun and support UHPP. There will be entertainment, food, and drink as well as a bevy of fantastic prizes (like signed Pat Bagley editorial cartoons)

UHPP staff will share our experiences from the past year in health reform, and what we expect in the future.

Purchase your tickets here!
Can’t make it? You can donate here!

UHPP’s Annual Fundraiser:
Date: Thursday, November 6th
Time: 6pm-8:30pm
Location: Tony Caputo’s Market and Deli (314 W. 300 S., SLC)
Ticket Price: $30 Adult Admission, $15 Student Admission
RSVP: https://www.eventbrite.com/e/uhpp-fundraiser-tickets-12627678727
More Information: Contact Laura Coyne at email, or phone, at 801-433-2299.

Event Highlights:

• Food, drink, and entertainment
• Grab bags with restaurant gift certificates and passes to museums
• Silent auction items include: Pat Bagley signed editorial cartoons, signed photographs of Utah Jazz players Gordon Hayward and Derrick Favors, plus day passes to the Deer Valley Resort

UHPP Honored for Community Outreach

The October 2014 issue of Utah Business magazine features their annual Healthcare Heroes winners—including UHPP, which received an award for our Community Outreach. 

Earlier this week UHPP joined 23 other honorees from Utah’s medical and healthcare community to be recognized at a luncheon event at the Hilton Salt Lake City Center.

Here’s what Utah Business wrote about us:

Utah Health Policy Project
Founded in 2006, Utah Health Policy Project (UHPP) is a nonpartisan, nonprofit organization that focuses on healthcare solutions for underserved Utahns. As the Affordable Care Act began to take effect, one of UHPP’s top priorities was enrolling as many Utahns in the new insurance options as possible. To that end, UHPP joined with other community partners to create Take Care Utah, a consortium of organizations that provides trained enrollment specialists to help people find and better understand their new healthcare options.
UHPP, working with United Way of Salt Lake 211 and the Association for Utah Community Health, is a federally funded lead administrator of the collaboration. “In some states, enrollment assistance, surprisingly, can be competitive. But we, in Utah, decided to work together to get the job done. We openly refer clients and share resources and best practices in the shared goal of maximizing enrollment into health insurance,” says Matt Slonaker, executive director of UHPP.

The results speak for themselves. Utah exceeded its 2013-14 enrollment goal by 148 percent, performing better than all of its peer states. It also enrolled the highest percentage among the “young invincibles” age group.

“Our goal was to simplify a complicated and controversial topic like health reform,” says Slonaker. “UHPP’s ‘just the facts’ approach emphasizes the needs of real Utah families and how the ACA might help them.”

PCN Enrollment Update

After adding 10,000 recipients in four months, PCN is now closed to childless adults.

Utah’s Primary Care Network (PCN) is closed to childless adults after four months of steady enrollment. Adults and caretakers with dependent children are still able to apply. Because PCN is a capped enrollment program, adults without dependent children won’t be able to sign up u

ntil further notice. The Department of Workforce Services (DWS) reported over 400 adults without children have been denied coverage under the program since the cap went into effect on October 1st. However, some of these individuals may not have been eligible for PCN.

PCN began accepting new applicants in early June. Since then, over 10,000 Utah adults have successfully enrolled. All of them earn below 100% of the federal poverty level (FPL) and are ineligible for both subsidized private insurance on healthcare.gov or current Utah Medicaid.

PCN began in 2002 as a Medicaid waiver program to offer limited coverage to low income parents or adults without children who didn’t qualify for traditional Medicaid. PCN is not comprehensive health insurance. It offers limited prevention-oriented health coverage, which includes primary-care doctor visits, up to four prescriptions per month, dental and vision care, immunizations and other services. PCN does not cover inpatient hospital care, mental health services, or specialty care—even with a primary care doctor’s referral. PCN covers emergency room visits on a case-by-case basis.

Currently, PCN has funding and federal approval to remain operational through December 31st, 2014. The Department of Health has submitted an extension request to Health and Human Services Secretary Burwell, but the fate of the program will likely depend on whether Utah lawmakers pass the Governor’s Healthy Utah Plan.

Receiving PCN is a temporary solution for the 45,000 Utahns who earn too little to buy subsidized insurance on healthcare.gov, but earn too much to qualify for Medicaid. These Utahns earning under 100% FPL fall into our state’s “coverage gap.” If the state enacts Gov. Herbert’s Healthy Utah Plan, current PCN recipients would transition to subsidized private insurance offered by that plan.

Healthy Utah in 2018

Three years after Utah implemented the Healthy Utah Plan in 2015, we look back on how it worked.

It’s October 2018 and the Utah Health Policy Project (UHPP) is going back in time.
The Utah Jazz are ready to defend their second-straight NBA title, President Schwarzenegger is installing a 1,500 sq. ft. weight room in the White House, and we’re reviewing how Utah’s healthcare landscape has changed in the three years since the Healthy Utah Plan became a reality across the state.
Don’t worry. It’s still 2014 where you are.
But UHPP has been to the year 2018, and here’s what we learned.

Where We Started

Before Healthy Utah our state’s insurance landscape contained many pitfalls for low-income, working families. A family could earn just below the federal poverty level ($19,790 for a family of three) and the parents wouldn’t qualify for either Medicaid or subsidized private insurance. Plus, many families at this income level can’t receive or afford insurance from their workplace. Any childless adult earning under $11,500 faced a similar dead-end. These pitfalls weren’t Utah’s fault, but the result of the Supreme Court’s 2012 changes to the Affordable Care Act (ACA). Almost 50,000 Utahns were stuck in this coverage gap.
These Utahns worked. They paid taxes. But they couldn’t afford health insurance.

As a result, the state’s uninsured rate in 2013/14 was between 11% and 14%. While other states were making dramatic reductions in their uninsured rates, Utah’s remained stagnant due the coverage gap.

By the end of 2014 it became increasing clear to Utah voters (statewide surveys #1, #2, #3) and many legislators that the economic and social costs of the coverage gap were hurting our state. That’s when the Healthy Utah Plan emerged as the most appealing Utah-based solution to solve these problems. It combined private insurance with Medicaid “wrap-around” benefits, while also adding co-pays, work incentives, and subsidies for people who couldn’t afford their job-based insurance. And it secured over $258 million in taxpayer funds that were already set aside for Utah.

How It Worked
In the three years since the Utah legislature approved the Healthy Utah Plan, Utahns have enjoyed seamless access to affordable healthcare coverage no matter how their jobs or incomes changed.
The results have been dramatic.

Utah’s Uninsured Rate Dropped
Within 18 months Utah’s uninsured rate fell by over 50 percent (similar to Arkansas and Kentucky after they expanded coverage), to 6 percent, letting Utah boast about having the lowest uninsured and unemployment rates in the country.

Families and Workers Stayed Healthier
The link between employment and health insurance isn’t coincidental.
One of the crucial points that convinced legislators to support Healthy Utah in 2015 was the fact that 66% of the adults in Utah’s coverage gap were working one or more jobs but couldn’t purchase or afford insurance. While 60% of Utahns receive insurance through their employer, almost all part-time jobs and many full-time jobs don’t offer job-based health insurance. Plus, even if a company offered insurance, many low-wage workers couldn’t afford the premiums.

The Healthy Utah Plan closed these gaps by creating private insurance plans to cover uninsured workers, and providing subsidies to make employer-sponsored insurance more affordable. The result was more Utah workers with health insurance who could deal with injuries and illnesses without threatening their jobs or families.

Disincentives Disappeared
Before the Healthy Utah Plan, a parent could fall into the coverage gap and lose their health insurance if their income rose above a certain threshold due to a new job, a raise, or combining salaries with marriage. UHPP met several families who refused raises or promotions because more income would have threatened their insurance. But these disincentives are now history, and families with rising incomes and ambitions can move seamlessly from Healthy Utah insurance to ACA insurance to employer-based insurance without worrying about falling through the cracks. Back in 2014 some critics claimed that the Healthy Utah Plan would “encourage families to break apart.” In fact, it gave Utah families more options to be insured and stay together. 

Uncompensated Care Went Down
Closing Utah’s coverage gap meant that previously uninsured patients who sought treatment at hospital emergency rooms now have access to primary care doctors, preventive care, and necessary prescriptions.

The old system saddled consumers with unpayable medical bills, and also created immense waste in Utah’s hospitals. The result was increased healthcare and insurance costs for everyone.
By 2018 uncompensated care costs at Utah hospitals—especially rural hospitals which faced their own set of unique challenges—decreased by nearly 50%, and patients are no longer putting off needed care.

Even in 2014 we were reading studies that indicated how lowering a state’s uninsured rate saved hospitals millions of dollars in uncompensated care. One compelling study showed how similar hospitals in Oregon (no coverage gap) and Tennessee (coverage gap) were diverging even after one year. Uncompensated care decreased 51.4% at the Oregon hospital, and increased 2% at the Tennessee facility. Thanks to the Healthy Utah Plan, Utah was able to achieve similar benefits and savings across our hospital systems.

Benefits for Utah Doctors
Before Healthy Utah over 20,000 Utah adults received basic primary care services through the state’s Primary Care Network (PCN)—a Medicaid program that didn’t provide specialty care or most emergency services. If you had PCN and your doctor wanted to refer you to a specialist for care, it was unlikely the doctor could make all the connections needed to facilitate the referral. That’s because PCN’s main focus was for primary care services, any specialty care provided to the patient had to be donated. Those hoops were eliminated by the private insurance market created by the Healthy Utah Plan, which enables Utah doctors and providers to practice medicine without their hands tied behind their backs. Doctors can refer to specialty services and know that their patients are getting the care they deserve.

Overcoming Early Challenges
Even with these positive outcomes, the Healthy Utah Plan experienced a rough freshman year. Enrollment started slowly with only 30,000 signing up the first year. Most of the early enrollees were transfers from the state’s phased-out PCN program.

Initial outreach proved challenging because: 1) Potential enrollees were often persistently uninsured; 2) People couldn’t believe it was true, and 3) Enrollment specialists had to determine if applicants were eligible for traditional Medicaid or the Healthy Utah Plan.

During the second year enrollment increased quickly as awareness of the Healthy Utah Plan spread, and state agencies and community organizations fine-tuned their messaging. We also learned how close coordination between navigators, brokers, and DWS workers helped consumers work through the enrollment website and application process.

Looking back to 2014 when Healthy Utah was just a good idea, we realize what an exciting three years it has been. But the impact of the Healthy Utah Plan spread beyond our borders, too. Soon after Utah adopted it in 2015, Wyoming, Montana, and Idaho closed their coverage gaps with similar plans. And over one million Americans will gain affordable health coverage as the Lonestar state finalizes its Texas Insure’Em Plan this month, followed by the implementation of Florida’s Peachy Plan in January 2018.
Embedded in both of those plans are the core ideas that first became a reality in Utah.

Healthy Utah Heads to the Hill

As the federal negotiations wind down, all eyes turn to the Utah legislature and their necessary but uncertain role in closing the coverage gap.

 

These are some of the tough questions we get at UHPP. 

• What is the Healthy Utah Plan?
• Why hasn’t Gov. Herbert moved faster to close the coverage gap?
• Who serves the best fry sauce in Utah?

And at least for the first two, we have good answers (we’ll let Training Table and Arctic Circle battle over fry sauce in another issue).

After two years of glacial progress—and occasional retreats—efforts to close Utah’s coverage gap are moving towards the legislative finish-line. 

As a reminder, the Healthy Utah Plan (1-page overview) is Gov. Herbert’s proposal to offer subsidized private health insurance to Utahns caught in the coverage gap. These are the 45,000 Utahns who earn too much or otherwise don’t qualify for Medicaid, or earn too little to receive premium subsidies to buy insurance on healthcare.gov. These Utahns—mostly working adults, many with kids—represent the last missing piece to Utah’s health coverage puzzle.

So far 27 states have either expanded Medicaid or pursued “private option” plans similar to Healthy Utah. According to the Advisory Board, the unofficial Medicaid Expansion score-keeper, Utah is among three states “considering expansion,” a category that does not include the “heck no” states like Mississippi, Alabama and Texas.

So what happened in Utah during the summer of 2014?

In a word: Tons. And the best-case scenario is that the Healthy Utah Plan will be debated and voted on in a special legislative session, or more likely during the 2015 Legislative General Session that begins in late January.

But we all know that best-case-scenarios rarely happen. Especially in Utah. Especially in the state legislature. Plus, the "conceptual" agreement between Gov. Herbert and the feds could unravel over the next few weeks. 

What we can say is that a host of stakeholders including local chambers of commerce, the hospital association, and the advocate community have made significant progress over the last two years—and leaps and bounds during the last few months.  

Here’s a brief update on what’s been happening on all fronts:

Negotiating with the Feds

Since March Gov. Herbert has been giving frequent updates  on the state’s ongoing negotiations with the federal Department of Health and Human Services (HHS). Staffers from both sides have whittled down the list of outstanding issues to about half a dozen. These issues—ranging from Utah’s requirement for higher cost-sharing for consumers earning above the poverty level, to extra charges for inappropriate use of the emergency room—were slowly turned from “red lights” to “green lights” as Utah gained approval from HHS. One of the last remaining “red lights” was Utah’s demand that participants seek work training or job assistance in order to receive their new health benefits.

On September 9^th Gov. Herbert reported from Washington, DC that he reached a “conceptual” agreement on the Healthy Utah Plan that cast the “work effort” requirement as component of coverage, not a prerequisite for coverage. The governor also described the negotiations as being 95% approved. After he announced the tentative agreement, he said Utah and the federal government should have the remaining details worked out within two to three weeks—which indicates a final agreement date in late September. We are now waiting for more detailed language on the “work-effort requirement” and whether it will be an “opt-in” or “opt-out” program administered in conjunction with the Healthy Utah coverage.

Gaining Public Support

Over the past few months we’ve seen numerous independent polls showing significant support among Utah voters to increase access to affordable healthcare coverage in Utah.  These polls also show strong support for the Healthy Utah Plan in direct comparison to other plans, or doing nothing.

Here’s a summary:

• UtahPolicy.com/Dan Jones Poll (link) | 54% of Utah voters prefer the Healthy Utah plan, 23% prefer traditional Medicaid expansion [September 2014] 
• Dan Jones/Notalys Poll (link) | 70% of Utah voters prefer the Healthy Utah plan, 30% prefer traditional Medicaid expansion (88% of Utahns support Healthy Utah over doing nothing) [June 2014]
• BYU Data Points Poll (link) | 43% of Utah voters prefer the Governor’s plan, 33% prefer traditional Medicaid expansion, 13% prefer to do nothing, 11% prefer the Speaker’s plan  [May 2014]

Healthy Utah Roadshow

From Logan to Provo to St. George, a group of community organizations including UHPP, Voices for Utah Children, AARP, and AUCH have been inviting community stakeholders to learn about the Governor’s Healthy Utah Plan from the experts who are putting it together. The events include a policy briefing, followed by an opportunity for local leaders to ask questions of representatives from the Utah Department of Health and the Governor’s Cabinet.  Each event has encouraged a lively exchange of ideas and generated significant local media coverage on this important issue.

So far we’ve held events in Provo, St. George, Clearfield, Logan, Ogden, and will hold one more in Taylorsville in early October.

Winners & Losers in Healthcare Reform

In August a national survey (Gallup Healthways Well-Being Index) indicated that the states who sought to maximize the benefits of the Affordable Care Act (ACA) also saw a dramatic drop in their uninsured rate. In one year, the uninsured rate in Arkansas dropped from 22.5% to 12.4%--a 45% decline. Kentucky saw a 42% drop.  The ten states that reported the largest declines in uninsured rates (see chart here) expanded Medicaid and established a state-based marketplace exchange or state-federal partnership.

Utah prides itself on being unique for a variety of reasons.

Some of Utah’s unique factors include:

• A low unemployment rate
• A lower prevalence of disease
• Lower than average healthcare expenditures
• A competitive insurance market.

But unless Utah increases access to healthcare coverage for its low-income residents, our uninsured rate—and the host of medical and economic burdens generated by inefficient health-care access—will continue to drag down our state

The Next Steps (Really) on the Healthy Utah Plan:

As Gov. Herbert’s staff finishes the federal negotiations over the Healthy Utah Plan, attention will turn to the Utah Capitol and the task of convincing enough legislators to vote their approval.

And if Gov. Herbert thought federal bureaucrats were tough and intransigent, then he hasn’t been attending enough Health Reform Task Force meetings.

For the past two years we’ve listened to earnest arguments like:

• Giving parents access to health insurance will make their kids worse off (link)
• Employers will drop their insurance plans for 400,000 (link), or maybe 200,000 workers (link)
• Expanding coverage to 45,000 people will eliminate 14,000 jobs (link)
• Charity care is a good alternative to access to health insurance (link)
• Access to hospitals can be dangerous for Utahns (link)

All of these arguments have been countered by facts and common sense.  It is time for Utah lawmakers to face this issue, learn the detailed arguments, listen to their constituents and special interests, and make a decision. After all, the upcoming general session will be the third legislative gathering in Utah to debate this issue—while 45,000 Utahns continue to live without access to affordable health insurance.

Want to Get Involved?

Refer to our Help Close the Coverage Gap article in this issue of Health Matters

  

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