Utah Governor Asks Obama to Certify State's Exchange as Compliant With ACA

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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 healthcare reform.”

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.”

Less Flexibility.

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,” he wrote.

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.

Innovations Rejected.

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 said.

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.

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