One you lose confidence, once you set a trajectory, it’s hard to get that trust back and that confidence. —Gov. Gary Herbert
SALT LAKE CITY — Changes to the Affordable Care Act proposed by President Barack Obama on Thursday won't likely have too much of an effect in Utah, as preemptive decisions by state lawmakers already grandfathered certain plans through the end of next year.
However, Obama's one-year extension of current policies may impact about 3 to 7 percent of Utahns who still have options, according to Jason Stevenson, education and communications director for the Utah Health Policy Project advocacy group.
He said people looking for new plans can use the federal health insurance marketplace (healthcare.gov) to shop for a new plan and determine their eligibility for financial assistance. In the meantime, those who have received cancellation notices can purchase short-term, monthly insurance coverage "to give you extra time," Stevenson said.
Holding the entire Affordable Care Act responsible for recent glitches and hold-ups, he said, is unfair.
"It hasn't been working well and it really has been hurting our ability to enroll people here in Utah, but it is not the entire game out there," Stevenson said. "There's a lot happening in the insurance marketplace in Utah and across the country where the Affordable Care Act is working."
He said the way the Affordable Care Act has played out so far "mirrors the rollout of many other large government programs."
"There are a still a lot of people in the pipeline to get more affordable, higher quality insurance," Stevenson said, adding that recent negativity doesn't reflect the good things brought about by the relatively new law.
Gov. Gary Herbert said Thursday during his monthly news conference on KUED Ch. 7 that a bipartisan solution to problems with health care reform needs to be found. But he warned that it won't be easy.
“One you lose confidence, once you set a trajectory, it’s hard to get that trust back and that confidence,” the governor said.
Herbert said the president has an opportunity to bring Republicans and Democrats together because “everyone seems to agree there are fixes that need to be made.”
The governor also called the rollout of the health care law “an abysmal failure” and said it is hurting the economy.
“Clearly the biggest problem I see is with the economic impact. The uncertainty of what the Affordable Care Act, Obamacare, is doing to the private sector is a big concern,” Herbert said.
That uncertainty, he said, is “having a significant negative impact on the marketplace. I think we all — any rational person — says this rollout has been an abysmal failure.”
Herbert also said he is still considering whether to expand Medicaid coverage in Utah, an option under the Affordable Care Act. He said he expects to make a decision before the start of the 2014 Legislature in late January.
"It's a very complex issue. It's easy for people to have a knee-jerk, do this or do that, or don't do this or don't do that, without understanding all the ramifications or complications," the governor said in a brief interview.
He dismissed a call by Utah's Family Investment Coalition for his upcoming state budget to include two scenarios, reflecting the projected costs and savings for both accepting the expansion and its accompanying federal matching funds, and not expanding Medicaid in Utah.
Herbert said his budget, expected to be released in December, "has no bearing on Medicaid expansion." He said he has no ability to propose two budgets for the state.
The coalition, a group of organizations that represent Utah's children, elderly and disabled, delivered a letter to the governor on Wednesday, saying that Medicaid expansion in Utah is the "fiscally responsible thing to do to fully support" families in the state.
"Two budgets will provide full transparency to the public and the Legislature regarding the fiscal implications of the expansion," the letter states. "Utahns need to be informed of the lost opportunity if the state rejects Medicaid expansion this year.
A Utah Department of Health-commissioned study completed earlier this year found that expanding Medicaid to an additional 123,000 Utahns could save the state more than $11 million in fiscal year 2015.
The governor said that's worth considering, but added: "I don't know that it's going to tip the scales one way or the other. In a $13 billion budget, $11 million is not enough to redirect our priorities but it's certainly a sizable amount of money."
It is estimated that nearly 60,000 currently uninsured Utahns would not be able to afford health insurance if the state does not adopt an expansion of Medicaid.
Herbert pledged his Medicaid expansion plan will take care of the most vulnerable Utahns but also protect taxpayers, both in the short and long term. "I think people do need to be taken care of," he said.
As part of the Affordable Care Act, states have the option to expand eligibility requirements to insure more low-income adults. The federal government has said it would cover the total cost of expanding coverage for at least the first three years and up to 90 percent coverage after that for the newly insured individuals.
States where leaders do not choose to expand coverage eligibility would leave the available federal funds on the table. Lawmakers and others have questioned whether the state should make a decision hinging on uncertain federal funds.
Contributing: Richard Piatt