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Utah's Avenue H better than federal exchange plan, health leaders say

Published January 24, 2013 9:30 am

Reform • Insurers, hospitals and large employers voice support for state's blueprint.
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Utah's health industry leaders on Wednesday said they want to keep the state's insurance exchange, Avenue H, arguing it would better serve taxpayers and employers than "an expensive and burdensome" federal version.

Some on Avenue H's 14-member steering committee — representatives for insurers United Healthcare and Regence BlueCross BlueShield — abstained from voting to approve the two-page endorsement, saying they weren't authorized by their companies to do so.

Vaughn Holbrook, director of health information collaboration for Regence, noted it's still unclear how much leeway the feds will give Utah and other states to design and run their own exchanges. Come 2014, the exchanges will become a primary path to health coverage for small businesses and individuals.

But consensus among the group was that some state control is better than none.

Utah Gov. Gary Herbert has positioned Utah's three-year-old web-based insurance portal as the "red state" alternative to those modeled on the first-ever exchange in Massachusetts. His plan for bringing Avenue H into compliance with the Affordable Care Act won conditional approval from the U.S. Department of Health and Human Services.

But negotiations continue over the details.

Herbert has pledged to open the state's exchange to individuals and to embrace consumer protections and price controls laid out in the health law. But he doesn't want Avenue H to become a tool for enforcing the requirement that people have insurance or for steering people to public aid.

The health law envisions exchanges as one-stop shops where people can see if they're eligible for the low-income health program Medicaid, or for federal subsidies to put toward their insurance purchases.

The governor believes Utah would do a better job with customer service than "some federal call center," and it can run a leaner exchange, sparing extra costs from being passed onto consumers, said Lt. Gov. Greg Bell. And unlike Massachusetts, which certifies which insurers can sell plans on its exchange, Utah wants to keep its marketplace open, thereby giving shoppers more choices, Bell added.

The industry's support could prove critical in winning over Republican lawmakers. Seated on the steering committee are Utah's major hospitals, health insurers and large employers, such as banks.

Tea party conservatives are pushing states to refuse to have anything to do with exchanges, believing they will fail, bringing the rest of Obamacare down with them. Other conservatives, however, see exchanges as a means to safeguard the private insurance market from a slide to a single-payer system, said Bell, who believes the Obama administration wants to work with states.

"They sense our good faith and want us to succeed," he said.





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