Tuesday, December 11, 2007

Governor wants $30 million to jump-start insurance for all

Gov. Jon Huntsman Jr. wants to make a $30 million "down payment" on a comprehensive, three-year proposal that would require all Utahns to be insured.
That money, which would expand eligibility for Medicaid and the Children's Health Insurance Plan (CHIP), is a significant first step toward implementing sweeping health-system reform in the state, Huntsman said.
"The way we go about handling health care is economically unsustainable," he said Monday, pointing out that health care costs in Utah grew at more than double the rate of inflation last year. Fewer than 60 percent of businesses now offer health insurance to their employees.
His plan, a confidential working draft of which was provided to The Salt Lake Tribune last week, "is about costs, and it's about quality and it's about access," he said.
But Huntsman, who deflected reporters' questions about the details of his plan at a news conference, said a blueprint won't be rolled out until the Legislature's caucuses can review it - which could be a few weeks away.
"This is an effort that is driven by the Legislature, by our office, by the business community and certainly by many advocates as well," he said. "So this is an all hands on deck effort and one we're taking very, very seriously."
The health system reform, according to the draft, would aim to cover the poor by boosting enrollment in state plans such as Medicaid, CHIP and Utah's Premium Partnership for Health [UPP], coverage for which nearly half of the state's 360,000 uninsured residents qualify.
The $30 million, included in the governor's budget recommendations for fiscal year 2009, would expand eligibility for Medicaid to those earning up to 200 percent of the federal poverty guidelines, up from 133 percent. For CHIP, children in families earning up to 250 percent would qualify, up from 200 percent, Huntsman said.
The next part of the plan would include devising a way to subsidize working families who don't qualify for these programs and can't afford private insurance; and creating consequences that force those who can afford health insurance to buy it.
One possibility, for instance, is to require Utahns to have a basic level of health insurance before they could apply for a job or register for higher education, according to the working draft.
The idea, said David Sundwall, director of the Utah Department of Health, is that if every Utahn were insured, health care costs would be contained.
"If everyone is covered there is not that opportunity for cost shifting," said Sundwall, who is involved in the health reform effort. "The sad thing is now we have people with no health insurance - but with very high health care costs - and they're what make the costs go up."
In a state such as Utah, he added, "the private insurance-based approach is the way to go right now."
While making individuals responsible for their health insurance will require a new mind-set for the state, Huntsman said, "it will have to be part of what we do." Over time, Utahns will "come to the logical end point that while it is burdensome at first glance, it's economically an imperative for our society."
Funds to create a statewide database to report health care costs and outcomes are included in his 2009 budget, as well as money to develop technology for health care providers to share such information.
"We've got to engage," Huntsman said, "and we're beginning that process."