When Brigham Young entered the Salt Lake Valley in 1847, he and the settlers he led were true pioneers. They blazed a new trail in making the desert blossom. Similarly, when the state's health care exchange was adopted in 2009, it was a pioneering effort. Utah was one of the first states to create this innovative health care plan.
Unfortunately, that pioneering spirit has evaporated in the last couple of years. Instead, the Herbert administration is resisting further innovation in the state's exchange that would increase access to affordable health care for Utahns. The governor is fighting the Obama administration over whether the state government needs to make the state's exchange even better.
Gov. Gary Herbert's decision to maintain the state's own health care exchange is a wise move. But the federal government is really asking Utah to do what it should have done all along. The governor should say that Utah would be happy to cooperate with Washington in improving health care coverage. Instead, he is insisting Utah's exchange is good enough as it is.
Yet, it isn't. Right now, the exchange covers 7,600 people and is used by 318 businesses. Compare that to the over 300,000 Utahns still uninsured. Utah's health care exchange program can be improved. Here are four ways:
One, it can allow individuals and larger businesses to participate in the program and not just small businesses. According to the Kaiser Family Foundation, even with the health care exchange, 14 percent of the state's population is still without health insurance. That means many Utahns don't have access to health care they need. Utah says it plans to expand to individuals and large businesses in the future. Good. The federal standard just assures that actually happens — and sooner than later.
Two, it can enforce the individual mandate under Obamacare. Clearly, this is an unpopular provision of Obamacare right now, but that will change once those who are currently uninsured realize their insurance will allow them to receive regular medical care they don't get now. This provision has the potential to cut costs since it will reduce emergency room visits and allow more people access to preventive care. That will make these Utahns healthier and less expensive for the rest of us.
Three, the state can include Medicaid as an option in the exchange and even expand Medicaid to allow more Utahns to participate. Gov. Herbert fears complying with federal government standards like this will make more people dependent on government programs. Unfortunately, the governor doesn't understand the needs of tens of thousands of Utahns who lack health care insurance now and depend on Medicaid to get decent health care. These are college students with families who are struggling to get an education. These are people who are unemployed and still looking for work in a recession economy. They don't want to be dependent. They just need decent health care provided by Medicaid.
Fourth, it can help distribute federal tax credits. These tax credits will help Utahns afford health insurance coverage. Again, the real beneficiaries are Utah's citizens who need those tax credits to buy insurance. Why would the state not want to help Utahns get this credit?
If the governor really doesn't want the federal government to take over health care in Utah, then he should upgrade the state's health care exchange to make it federally compliant. That way the state runs the program, but it meets the real health care needs of Utahns. This is a win-win situation for all.
After that, the state should go back into pioneering mode and move beyond the federal standards to find more ways to reduce health care costs, handle the growing need for doctors and nurses, and assure that all Utahns are able to receive access to decent health care. That would be the spirit Utah's original pioneers brought to their problems. We need that same spirit today from Utah's government.
Richard Davis is a professor of political science at Brigham Young University. Email: Richard_Davis@byu.edu
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