We hope there is no doubt in his mind we do not want to run this exchange for the feds. We don't want to touch it with a 10-foot pole. —House Speaker Becky Lockhart, R-Provo
SALT LAKE CITY — Republican legislative leaders made their views on whether Utah should get involved in a federal health insurance exchange loud and clear in a letter to Gov. Gary Herbert.
"We hope there is no doubt in his mind we do not want to run this exchange for the feds," House Speaker Becky Lockhart, R-Provo, told members of the GOP House caucus Wednesday. "We don't want to touch it with a 10-foot pole."
The governor must tell federal officials by Friday whether Utah intends to run a state-based health insurance exchange mandated by the Affordable Care Act, often referred to as Obamacare, or leave it up to the federal government.
Herbert, who was meeting with other members of the Republican Governors Association on the issue Wednesday in Las Vegas, remained undecided. He had supported the repeal of the federal law, upheld earlier this year by the U.S. Supreme Court.
"The governor will announce his decision once he makes his decision," said his spokeswoman, Ally Isom, noting the federal government is "demanding a decision" without providing sufficient information about its impacts.
"We simply have more questions than answers, and the governor shares the same concerns legislative leaders have when it comes to determining a course for Utah's health exchange," Isom said.
The Republican Governors Association ended up sending its own letter, this one to President Barack Obama, asking for the Friday deadline to be pushed back until there is more information available from the Democratic administration.
The letter, written on behalf of the country's 29 GOP governors and two governors-elect, states that "putting in place the new programs you championed will be an enormous strain on state governments and budgets, as well as the federal government."
The Republican governors warn that the time frame and many of the law's provisions "are simply unworkable," given the financial obligations and complex technicalities involved in setting up the new infrastructure needed.
Utah's GOP legislative leaders said in their letter to Herbert that Utah should not spend any state time or money to build and run the exchange program — or even work in partnership with the federal government.
"The federal exchange is being built to implement federal advanced premium tax subsidies, to enforce an individual insurance mandate and to impose insurance mandates on employers," the letter from legislative leaders states.
"These are not Utah health reform initiatives, and the funding and resources needed to develop this federal program should not be borne by Utah's citizens," it concludes.
The legislative leaders say they are committed to preserving state control over Utah's insurance market, but for now, the federal government needs to spell out how the exchange will operate and how it will be funded.
"Until that information is provided, and until we know that federal funding is available to pay for federal health reform, we do not want Utah to build and pay for a federal program," the letter states.
Retiring Senate President Michael Waddoups, R-Taylorsville, said lawmakers don't want to be put in a position of having to pay for a federal program they don't support.
"We don't want to be tagged with the costs we think are associated with that plan," Waddoups said. "We might not only have to be taking credit for some of it, we may actually have to be raising taxes to fund that program. I don't think Utah is prepared to do that. We want any costs to be borne by those that instigated it."
Waddoups said the future of the state's more limited health care exchange, now known as "Avenue H," is in question. He said it could be turned over to the private sector, merged into the federal program or allowed to "die a noble death."
Lockhart told a reporter the state may end up in court over concerns about the impact of the federal health care law on the state, including on the state employee health insurance plan.
"It would be on the table, absolutely, if that is an option for us. We need to look at all the options," the speaker said, citing the increased costs to taxpayers associated with the new law.
On Tuesday, legislative leaders were warned that the state faces up to a $40 million fine under the law that takes effect in 2014 if state employees who work more than 30 hours a week are not provided with health insurance.
Retiring House Minority Leader David Litvack, D-Salt Lake, said Democrats have not taken a position on whether the state should be involved in a federal health insurance exchange.
Litvack, who like Waddoups did not run for re-election, said he wants to know the reasoning behind the GOP position.
"What's the pragmatic or the practical way to go? Some would say it makes a lot of sense to have the state run the exchange," Litvack said. "I would hope this is not political. I would hope it's not a statement, ‘We don't want to play.'"
Members of the GOP House caucus heard a presentation on the deadlines facing the state on the health care law from legislative attorney Cathy Dupont.
"It's a huge amount of change," Dupont said.
She said there are issues that lawmakers will want to consider in the 2013 Legislature, including whether to expand Medicaid as allowed under the new federal law.
Dupont suggested that lawmakers consider negotiating with the federal government on that and other issues associated with the law, calling it an opportunity for them to "get as creative and pushy" as they want.