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Small-business health care reform to start Sept. 1

Published: Wednesday, Aug. 18 2010 9:49 p.m. MDT

SALT LAKE CITY — It may have taken years for the federal government to pass legislation to reform health care, but Utah policymakers are on the fast track to putting the state's health care plan into action.

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.

Plans for the launch were laid out Wednesday during a meeting of the Health System Reform Task Force at the state Capitol.

The state is drawing strong support from local activists for its leadership role in executing its health care plan.

"On most of these things, Utah will do a better job of running this (program) with more local control," said Judi Hilman, Utah Health Policy Project executive director.

The organization is a nonprofit health advocacy group based in Salt Lake City.

"(Utah) has a much stronger commitment to cost containment and also to get consumers to make good choices … and use their health care wisely," she said.

In addition, Utah has practical experience in running a successful health coverage program, Hilman said.

Established in 1991, the Utah Comprehensive Health Insurance Program — or HIPUtah — is a state-subsidized plan that serves as a safety net for Utahns with serious medical conditions such as cancer, diabetes, heart disease and other chronic illnesses that make them medically uninsurable.

The new health care law also creates the Pre-existing Condition Insurance Plan — a "temporary high-risk health insurance pool program" — to provide coverage to currently uninsured individuals with pre-existing conditions who have been without insurance for at least six months.

The Utah Insurance Department will run the federal program in conjunction with its existing state high-risk pool.

HIPUtah is a nonprofit entity within the department that will run PCIP as a separate program under the name Federal-HIPUtah.

HIPUtah currently provides coverage for 4,100 individuals.

Federal-HIPUtah is a federally subsidized insurance plan that will offer transitional coverage until 2014 when health insurance exchanges become available and pre-existing condition exclusions are prohibited. Federal-HIPUtah will receive $40 million to provide coverage for an estimated 2,400 Utahns.

Eventually, all Utahns participating in the high-risk pools will be eligible to transition into the federal insurance exchange beginning on Jan. 1, 2014, according to Tomi Ossana, executive director of HIPUtah.

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.

"By that 'consumerism' taking place, it's one of those first steps in health care reform … taking ownership as a consumer," said Matt Spencer, program manager with the Utah Office of Consumer Health Services. "That is the direction we're going."

Spencer said the goal for the state reform efforts is to devise a plan that best serves the health care needs of Utahns.

He said the state will take on a limited role of aggregating information for consumers to review and make choices that will best suit their individual requirements.

"It may not work in Nebraska … in Florida or New York," he said. "As facilitators, we're allowing market forces to work (and) allowing consumers to be empowered."

For information on eligibility and plan options, visit www.insurance.utah.gov/hiputah/index.html or for program questions, call 801-442-6660.

e-mail: jlee@desnews.com

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