This week the Health Reform Taskforce presented its annual report, including several studies and recommendations that will be made to the Utah Legislature next year. Here are a couple of highlights from the report.
- As insurance premiums continue to climb, the report recommends the evaluation of a possible state-based reinsurance program or high risk pool to help contain costs;
- As individual and small-group market insurance participation continues to decline, the report recommends continued examination of how those markets will function; and
- To address the default/insolvency of Arches Health Plan, the Taskforce is considering whether Utah law should be amended to include health maintenance organizations in the Utah Life and Health Insurance Guaranty Association, created to protect consumers against insolvency issues. The report did not make a recommendation on legislation in this area, but a bill is expected in the 2018 session.
Representative Jim Dunnigan also discussed the passage of the Medicaid Waiver that will expand Utah’s 1115 waiver to include previously non-eligible groups (focusing on single adults without dependent children). Those groups are:
- The chronically homeless;
- Those impacted by the Justice Reinvestment Initiative; and
- Those with a substance use disorder or mental health illness
Utah’s waiver was approved on November 1 – just in time for the open enrollment period. Other points included in the waiver is the State’s ability to open and close enrollment based on budget, an IMD exclusion for substance use disorders so that Medicaid providers may have facilities with more than 16 beds, etc. This is the first Utah part of the waiver and does not include the work requirement. Individuals are eligible for 12 months of continuous coverage, regardless of any change in their household income over that year. UAC appreciates the continued work of Representative Dunnigan to serve this extremely vulnerable population.
Finally, Representative Steve Eliason presented a bill that expands the Primary Care Network to include additional services that mirror the current Medicaid benefit. This would grant those in the Primary Care Network additional resources such as mental health services. The bill is still in the preliminary stages and Representative Eliason is taking suggestions on improvements.