Many Republican politicians in Utah despise the notion of federal involvement in things like affordable health insurance. So, a few years ago, they established what is now called Avenue H, a health insurance exchange for small businesses and their employees.
At present, business owners give an average of $437 a month to help their employees get insurance. But, as of November, Avenue H served just 313 such businesses and covered only 7,429 people.
That's out of about 67,000 small businesses. Meantime, more than 400,000 Utahns lack health insurance.
Now, much to the dismay of lots of conservative residents and politicians, President Barack Obama's Affordable Care Act (ACA) is about to come to fruition. Like it or not, the ACA is a much better deal for all Utahns, insured or not.
On Thursday, nearly 100 health professionals, legislators and others gathered in Salt Lake City to hear a presentation by the nonpartisan, nonprofit Utah Health Policy Project.
"Let me note in passing that we're facing deadlines," said Judi Hilman, UHPP's executive director, "but we have yet to resolve state health-reform incompatibilities with federal health care reform."
And, she added, the Utah Legislature, which convenes Jan. 28, is about a week away from having to make "monumental decisions."
And now that the U.S. Supreme Court has upheld the ACA and Obama has won a second term, it's time to understand that trying to get around it isn't an option.
Earlier this month, the U.S. Department of Health and Human Services gave Utah conditional approval to develop a state-run health exchange. Meantime, the state is working with the feds to make Avenue H compliant with the ACA, according to the UHPP, including an expansion to individuals.
Deadlines are coming up quickly. The ACA begins open enrollment Oct. 1, meaning that legislators will have to support Avenue H's efforts to set up the state-run exchange.
Medicaid and the federal Children's Health Insurance Program are also parts of the equation. Medicaid provides coverage for children in low-income families as well as pregnant women and people with disabilities but not childless adults. The feds finance 70 percent of Medicaid costs and the state 30 percent.
Then there's the issue of Medicaid expansion, which would cover far more eligible Utahns. The federal government would cover 100 percent of that expansion for the first three years, phasing down to 90 percent by 2022, according to the UHPP.
Again, Republican state leaders have warned that money for education and transportation may shrink if Medicaid is expanded. But this past week, the Salt Lake County Council voted 8-0 four Republicans and four Democrats to prod the governor and lawmakers into accepting the expansion.
The Affordable Care Act is despised by many, but if managed correctly, it will work. That means millions of Americans will be able to get health insurance, saving those of us lucky enough to have it already a bundle of money. It also greatly expands and stabilizes the private insurance market.
It's not socialism or welfare, as some claim. It's just good old American good sense.
Peg McEntee is a news columnist. Reach her at email@example.com, facebook.com/pegmcentee and Twitter, @pegmcentee.