Search This Blog

Tuesday, October 21, 2014

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 (1st and 3rd 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
Get involved here

ACA Timeline

November 5, 2014
Deadline for final determination of Utah insurers selling policies on and Avenue H.

November 15, 2014
Open enrollment begins on 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

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 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 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 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 makes you want to binge-watch Toddlers & Tiaras, we’ve got you covered.

Contact the trained enrollment experts at Take Care Utah (TCU, 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 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 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: 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
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 


Ask a Navigator

Q: Will work better this year?  

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

As you might now, 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 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 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

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 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, or calling 2-1-1.

Until next time!

Take Care Utah
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
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 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, 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.