By Louise Norris
March 7, 2014
By February 1, the number of people who had finalized their plan selections in the Utah exchange had grown to 29,419 – an increase of almost 11,000 people since the end of December. 31% of those applicants are between the ages of 18 and 34, ranking Utah well above the national average of 25%, and second behind only the District of Columbia in terms of the percentage of young people who have enrolled. This is very good news for premium stability in the Utah exchange, as younger people tend to have lower healthcare costs than older people.
An additional 31,646 people had enrolled in Medicaid through the Utah exchange by the first of February.
Utah has been politically divided on the ACA, with some lawmakers championing HCR10, a non-binding resolution detailing the “devastating impacts of the ACA” that was signed by Governer Herbert in April 2013. But on January 23, Gov. Herbert announced that Utah would expand Medicaid, saying that “doing nothing is not an option” and noting that there are 60,000 people in Utah who would be left in a coverage gap if the state did not expand Medicaid.
As of early March, the state has not yet expanded Medicaid, but is one of four states that are currently considering the possibility. Gov. Herbert is pushing a privatized version of Medicaid expansion that would provide subsidized private plans to people with incomes up to 138% of poverty level (those between 100% and 138% would pay a small portion of the premiums). The state is still negotiating the details with HHS.
Along with Massachusetts, Utah has a health insurance exchange that predates the Affordable Care Act. However, unlike the exchanges called for by the Affordable Care Act, Utah’s exchange is not open to individual consumers to purchase health insurance. That fact has led to a series of discussions and negotiations between the state and the U.S. Department of Health and Humans Services (HHS) — and ultimately, a unique approach that is attracting interest from other states.
The Utah Health Exchange for small businesses was established in 2009 and rebranded as Avenue H in October 2012. Avenue H offers a “fixed contribution” approach for small employers. An employer contributes a fixed amount toward each employee’s health insurance. An employee then uses the exchange website to pick an insurer and policy to fit his or her individual or family needs. According to an article in The Salt Lake Tribune, about 350 businesses provided health insurance to about 7,800 people through Avenue H.
Gov. Herbert asked President Obama to direct the U.S. Department of Health and Human Services (HHS) to approve Utah’s exchange and to consider it a “minimum standard” for an ACA-compliant state-based exchange. In January 2013, HHS granted conditional approval for Utah’s exchange while maintaining that it must be expanded to serve individual consumers. Herbert continued to lobby for HHS to accept the Avenue H “as is” and proposed in February that the state continue running its small business exchange and that the federal government operate the individual exchange. In May, HHS and Utah reached an agreement for this dual-model approach, and Utah moved forward with two separate exchanges – small business run by the state and individual run by HHS – when open enrollment began for individual policies in October. New Mexico has also adopted a hybrid approach, but the specifics are different.
Six health insurance carriers are offering a total of 99 policies through Utah’s federally-run individual exchange: Altius Health Plans, Arches Mutual Insurance, BridgeSpan Health, Humana Medical Plan of Utah, Molina and SelectHealth. Rates in Utah are lower than the national average. Across all age groups, the average lowest cost bronze plan in Utah is $201/month before subsidies, compared with a national average of $249. A report released in February 2014 found that Davis and Salt Lake are among the least expensive regions to purchase health insurance in the US; the two county region ranked 7th on a list of the ten least expensive health insurance areas.
Three companies — Arches Mutual Insurance, SelectHealth and UnitedHealthcare of Utah — are selling small group policies through Avenue H in 2014.
According to Kaiser’s State Health Facts, about 14 percent of Utah’s population is uninsured.
Use the federal marketplace to enroll in individual or family coverage beginning Oct. 1, 2013
Utah’s exchange for small businesses (Small Business Health Options Program, or SHOP)
Health Insurance Division Consumer Service
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in Utah.
State Exchange Profile: Utah
The Henry J. Kaiser Family Foundation overview of Utah’s progress toward creating a state health insurance exchange.
Let your Utah governor and legislators know how you feel about the state’s proposed health insurance exchange.Utah Governor Gary R. Herbert