Utah’s Health System Reform
Utah’s leaders heard the cries for help from Utah small businesses and consumers around the need to address access, cost, and quality within our health care system. Utah embarked on state-level health system reform in 2008. Since then, 4 key pieces of legislation have shaped Utah’s health system reform (see table). For more about the history of Utah’s health reform efforts read our paper “A Brief History of Utah’s Health Reform Efforts.”
Federal health reform (the Affordable Care Act, or ACA) became the law of the land in 2010. Federal health reform complements the state’s reform efforts. UHPP’s Implementation Station will help you make sense of the new law and how it interfaces with state reform efforts.
Utah’s Health System Reform Timetable
||HB 133 Health System Reform
Created the Health System Reform Task Force and the Utah Health Exchange
||HB 188 Health System Reform-Insurance Market
Created virtual store front for the Exchange; introduced the defined contribution market
||Limited launch of Utah Health Exchange
99 small businesses started the enrollment process; 19 dropped out due to application issues; more dropped out due to high premium quotes; by the end, only 11 remained
||HB 294 Health System Reform Amendment
Intended to fix problems presented during limited launch; created an Exchange Advisory Committee
||Addition of a large employer pilot to Utah Health Exchange
Announced that the pilot program would be extended to several large companies in order to lower costs
||HB 128 Health Reform Amendments
Strengthens the Exchange; requires insurer transparency on the Exchange; removes large pilot (re-focus Exchange on small businesses)
Utah’s health system reform is grounded in the private market and based on the principles described in the 2010 document Utah’s Comments on Exchange Regulations by Norman Thurston, PhD, Health Policy and Reform Initiatives Coordinator, Utah Department of Health. Utah’s health reform principles include:
- Consumer choice should be maximized
- Consumers should be empowered to make better decisions about their health and health care
- Minimal intrusion from state government: “The invisible hand of the marketplace rather than the heavy hand of the government” should promote real progress in reform.
Utah’s Health Exchange
The cornerstone of Utah’s reform is the Utah Health Exchange—a web portal where Utah’s small businesses can buy health insurance. The goal of Utah’s Exchange is to “decrease the ranks of the uninsured,” but progress towards this goal has been slow –only around 20% of the small businesses that buy health insurance through the Exchange did not buy health insurance before. That means that the UHE has brought, at most, 840 individuals into health insurance coverage so far (see “The State of the Utah Health Exchange”). For more information visit our Exchange page. To track the progress of Utah's Health Exchange check out our Exchange Watch.
Utah law requires that the UHE convene an advisory board with representation from insurers, brokers, the departments of health and of insurance, consumer advocates (community based non-profits), and small business. The Exchange Advisory Board met monthly until June 2011 at which time it was dissolved by the Office of Consumer Health Services. UHPP summaries of those meetings are available here.
The advisory board was replaced with a 4-part structure: 2 closed door separate “round tables,” one for insurers and one for brokers; an ad hoc consumer advocate group (not yet formed); and an Executive Steering Committee (ESC). The ESC technically fills the same seats as required in statute for the Utah Health Exchange Advisory, but fails to fill the statute in spirit. The individuals chosen to represent consumers by filling the “community-based non-profit organization” seats are top level executives, far removed from working with consumers (see our October Health Matters, “Good Governance: Who’s Keeping an Eye Out For You?” for more information).
UHPP hosts U-SHARE (Utahns for Sustainable HeAlth REform), a coalition of organizations and individuals dedicated to supporting the implementation of state and federal health reform measures that ensure affordable access to quality care for all Utah residents. Click here to go to U-SHARE's website.
For a list of Fact Sheets and Papers on Reform Initiatives click here.