Health exchanges

Utah legislative leaders seem willing to give the federal government control of an essential service that Utahns need, for the illogical reason that they don't like the federal government.

The essential service is health insurance. Under the federal Patient Protection and Affordable Care Act, all Americans who are not covered by Medicare, Medicaid or the Veterans Administration and do not have employer-provided insurance will be able to shop for health insurance on "exchanges" that list insurers and the costs of their plans. The low-income uninsured may be eligible for subsidized premiums.

The deadline for states to set up such exchanges was extended into 2013. If states don't do it, the federal government will do it for them. Utah legislators say they want no part of it, although Utah is one of the few states that already has a working health-insurance exchange.

House Speaker Becky Lockhart, R-Provo, said, "This is a federal government program, the federal government passed it. The federal government decided to do all these taxes. We don't want to touch it with a 10-foot pole."

Avenue H, as the state's exchange is called, is limited to small businesses and doesn't yet have a robust clientele, but the machinery is in order. The state would have to make changes to fit the ACA requirements, but it could be done relatively simply compared to starting an exchange from scratch. That is what the state should do so it can retain authority to regulate the insurance markets and enforce the decisions that the ACA leaves to it.

Gov. Gary Herbert, who will make the final decision whether to keep the exchange in Utah hands or let the feds set up another, is rightly taking a more measured approach. He has sent a letter to the federal Department of Health and Human Services with a list of questions, mostly regarding funding of the exchange and requirements that insurers must meet.

Herbert also joined with 29 other Republican governors who wrote to President Barack Obama telling him of their concerns, especially about the states' responsibilities in paying the cost of the exchanges.

Herbert is right to perform this due diligence. The ACA is a complicated law, and the governor can't be expected to understand all its complexities. But the health care reform law, passed in 2010 and upheld this year by the U.S. Supreme Court, is not going away. Utah leaders should put aside their distaste for Washington and do what is best for Utahns, as they did when they accepted million of dollars in federal stimulus money during the Great Recession.