SALT LAKE CITY — Utah Gov. Gary Herbert announced Friday that his state will stick with its own existing health insurance exchange rather than let the federal government run one for them.
Herbert announced the decision by making public a letter he sent to U.S. Health and Human Services Secretary Kathleen Sebelius, saying there are several problems with federal exchanges and that he would prefer a state-based approach to stay true to "Utah principles."
Herbert, a Republican, wrote that he intends "to move forward with Utah's version of an exchange" and requests that HHS certify it as compliant with the new federal law.
Analysts say Utah's exchange needs significant changes to comply with the Patient Protection and Affordable Care Act, since it doesn't offer health insurance to individuals and is not set up to distribute federal tax credits aimed at low income people who are uninsured.
Utah officials say they will expand the exchange to include plans for individuals. The governor's office sent out a chart showing nine areas where Utah's exchange differs from the kind envisioned in the federal health care law.
The document refers to the federal version as a "complex network of systems" that covers public and private sectors. Utah's plan is a "narrower enterprise that focuses exclusively on supporting choice and competition in the insurance market," the document says.
Herbert said in his letter to Sebelius that his staff will submit detailed documentation of Utah's exchange and point out how it compares to requirements in the federal law.
"I am confident that when you do, you will find it meets the broad goals and objectives," Herbert wrote.
Friday was decision day for states to notify the federal government if they will set up their own insurance exchanges under the federal health care law.
Exchanges are online health insurance marketplaces pioneered in Utah and Massachusetts. Utah's exchange was launched on a limited basis in 2009 and fully implemented two years later.
Utah becomes the 18th state to decide to set up and run its own market, according to monitoring by The Associated Press. The administration has already started granting approvals to these states.
On the other side of the ledger, there are 19 states that have refused to run their own programs and put it back on the federal government. All those states are led by Republican governors.
Nine other states have indicated they want to pursue a partnership with Washington, and more may do so.
Only four states remain undecided.
Herbert's letter to Sebelius was the latest in a series of communications over the exchange. Herbert sent a letter early in the week asking President Barack Obama to approve Utah's exchange and declare that it meets the requirements of the federal health overhaul. She responded with a message Thursday, saying the federal government wants to work with Utah to certify the state's exchange. He responded by announcing that the state would continue to move forward on its own.
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