Rather than simply reject Utah's puny attempt at an online health insurance exchange which, by law, it had every right to do the U.S. Department of Health and Human Services has graciously offered to work with Gov. Gary Herbert in building the project with the children's TV show name into something that will pass statutory, and moral, muster.
And it's going to take some work.
To its credit, Utah launched Avenue H well before health insurance exchanges were cool. Certainly before they were required by the Affordable Care Act, aka Obamacare. The idea, which dates back to the Jon Huntsman administration, is to create a more competitive marketplace in which small business owners can shop for the best insurance plans for their employees, theoretically using the power of the marketplace to push prices down and quality up.
But there are several things lacking in Avenue H. Which is to be expected, given that Herbert favors a "bare minimum" offering.
At first, Avenue H was only available to small businesses, not to individuals who are self-employed or who work for a business that doesn't offer health insurance. Without such a feature, the exchange was embarrassingly close to useless. And far short of ACA standards.
Utah already had plans to open the exchange to individuals, one reason why HHS Secretary Kathleen Sebelius gave it the provisional approval it received Thursday.
Still to be accomplished, though, are such features as a more aggressive consumer outreach, to make sure more people know about the exchange and what it offers. It will have to be properly integrated with information about, and links to, the federal health insurance subsidies that the ACA makes available for those in an eligible income range, as well as a process for directing those who are eligible for Medicaid to that program.
The idea that all Utah had to do to place affordable health insurance within reach of practically everyone was to set up an Internet bazaar and let nature take its course never made any sense. And now that it is clear that Obamacare is here to stay, it would be pointless for the state to use the development of its exchange as a bargaining chip for its resistance to, say, the individual mandate or any other part of the law.
Pointless, and cruel. The idea here is to extend health insurance to everyone, or as close to everyone as humanly possible. Anything Utah does to frustrate that aim is mean, illegal and will end up ceding the whole issue to the feds.