State-based health reform wins House approval

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State health reform got a boost Tuesday with House passage of a fix-it bill to improve the Utah Health Exchange, an online tool for purchasing health insurance.

Pitched as a free-market approach to lowering costs for small businesses, the exchange has had limited success. Only 400 people are receiving health insurance in its experimental first stage. And some of its 66 plans are up to 130 percent more expensive than what some companies were already paying.

That's because insurers are calculating premiums differently "inside" and "outside" the exchange, said House Speaker Dave Clark.

He toyed with the idea of combining the two markets and requiring insurers to offer small-group plans through the exchange. But loathe to impose government mandates, Clark settled instead upon other consumer safeguards.

Chief among them: HB294 would have insurers calculate risks over all small-group policies, rather than considering policies inside and outside the exchange differently.

The bill also would prohibit insurers from taking into account certain pre-existing health conditions when calculating employees' premiums. It would create a consumer advisory group and require insurers to publish claim denial rates and customer satisfaction ratings.

Finally, the bill would welcome large employers in an effort to drive down premiums, said Clark, who pitched the bill as "Utah's chance to show the federal government that Utah knows what's best for Utah."

Clark stressed the bill carries no mandates for insurers or consumers. "We are simply asking [insurers] to play by the same rules within and outside the exchange," he said.

The measure passed the House 62-13, but not unscathed. The bill moves forward with a string of nine amendments that health reform advocates say weaken its intent.

"Politically, philosophically, it's probably as strong as the bill can be," said Judi Hilman, executive director of the Utah Health Policy Project.