Coverage for all | The Salt Lake Tribune

Replace Utah's PCN with Medicaid

This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

In 2002 — before anyone had ever heard of Barack Obama, much less of Obamacare — Utah launched its own plan to provide medical insurance to people who were too well-off for Medicaid but not financially within reach of any other health care plan.

The Primary Care Network was launched under the leadership of then-Gov. Mike Leavitt, who knows a thing or two about health insurance, having come from the insurance business and later moving on to be, among other things, head of the federal Department of Health and Human Services under George W. Bush.

Now HHS, under President Obama, is waiting for Utah to decide if it will join the many other states in expanding Medicaid eligibility to the point that PCN will no longer be necessary.

Utah should expand Medicaid. It should not allow its pride of authorship of PCN to stop that move. Expanded Medicaid would provide necessary services to many more people, saving some lives and improving the quality of many others, even as it sharply cuts down on the cost-shifting that happens when hospitals have to write off unpaid bills from uninsured patients or local governments have to pony up for such things as mental health care.

And it would do so, mostly, on the federal dime.

But, if political face-saving is necessary, current Gov. Gary Herbert and other state officials can make the case that the feds are just now catching up to Utah's realization that there needs to be a bridge between Medicaid and private, or employer-provided, health insurance. And the federal money would expand the coverage to far more than the 25,000 Utahns who can be covered by PCN at any one time.

PCN provides a limited menu of health care services at a nominal charge for adults who haven't reached Medicare age and have incomes of no more than 150 percent of the poverty level. It was, and is, a Made in Utah idea that recognized and filled a need, even as it implicitly rejected the notion that free health care is readily available to the uninsured at hospital emergency rooms.

Emergency rooms do not provide health care. They provide trauma care: gunshot wounds, auto accidents, acute illnesses that require, and respond to, immediate treatment. Real health care — the prevention and treatment of chronic conditions from diabetes to cancer — requires insurance, or considerable wealth.

PCN was that insurance for 25,000 Utahns. Expanded Medicaid would be that insurance for 123,000 Utahns. It is time to trade up.