DENVER--Saying that he wants Utah's insurance exchange “to survive and thrive
as we originally envisioned it,” the state's governor asked President Obama to
certify the exchange as complying with the federal health care reform law.
In a Dec. 10 letter, Utah Gov. Gary R. Herbert (R) said he hopes the state's
exchange, which was created before the Affordable Care Act, can become “a model
for other states to use as a platform for their own versions regarding
The governor also asked the president to instruct the Department of Health
and Human Services to declare the Utah exchange model as the minimum federal
standard for ACA-compliant exchanges. “I am confident that if you make this
change, several other states will join Utah and request certification for 'state
based exchanges' based on our model, thus spreading a proven approach that
lowers costs and increases access,” Herbert said.
Obama has “supported giving flexibility to the states,” Herbert noted.
“Certifying our current exchange will give us that flexibility.”
Herbert noted Utah is required to inform HHS of its plan regarding a federal
health benefit exchange under ACA by Dec. 14, and he asked for “help” regarding
his requests before that deadline.
The governor said the Utah exchange “is now fully functional, offering a
choice of 140 health insurance plans to 7,646 individuals in 318 small
businesses throughout Utah. We are now embarking on a dramatic expansion of our
exchange to more small businesses and we plan to include individuals and larger
businesses in our exchange in the near future.”
By contrast, the governor wrote, HHS officials' current interpretation of ACA
is to require states to take a more government-centric, standardized approach to
exchanges. “This results in less choice and more reliance on public programs,”
For example, Herbert said, the state is “committed to helping those who need
the support” of Medicaid and the Children's Health Insurance Program. “However,”
he noted, “we never intended for our exchange to administer Medicaid, enforce
the individual mandate, or distribute federal tax credits.”
An HHS spokesman was not available for comment on Herbert's letter.
Herbert said that Utah has developed several innovative proposals to reduce
costs, increase quality, and assure access to health care for Medicaid
recipients. But when it has submitted waiver requests, HHS officials “met them
with either reluctance or rejection.”
The governor submitted a list to the president of
all Medicaid requests it has submitted since 2007. Seven of the nine were
rejected, Herbert said.
“When HHS cherry-picks parts they favor and rejects other vital plan
components, it becomes impossible to accomplish our overall objectives,” he
By Tripp Baltz
The governor's letter is at http://op.bna.com/hl.nsf/r?Open=bbrk-92vsgd.
The list of Utah's Medicaid waiver requests since 2007 is at http://op.bna.com/hl.nsf/r?Open=bbrk-92vset.