Op-ed: Healthy Utah plan good for Utahns and Utah business

This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

I've spent most of my life working to build our group of auto dealerships. Much of the business success I've found over the years comes in part to a team of terrific employees —one of the many reasons why I've made sure to offer a competitive compensation package that includes a solid health insurance plan for the people who I depend on to help my organization thrive.

But as the debate over both Obamacare and how to expand health coverage in Utah continues, there are many stories that demonstrate that not all employers view health insurance as a necessary expense for a variety of reasons. This lack of access to health care can be devastating to so many families who find themselves in a bind over how they can afford to keep themselves healthy through seeking primary care, or, in more dire circumstances, how they will finance life-saving health care in an emergency or in the wake of an unexpected diagnosis.

While selling cars is the business I know the most about, my interest and passion for health care led me to serve on the community board for University of Utah Hospitals and Clinics, where I've heard the heartbreaking stories of patients who've struggled to find basic health care insurance. These human stories are the ones that influence me in the most in my support of Gov. Gary Herbert's current "Healthy Utah Plan." I was pleased to discover recently that I am not alone in my support, as 88 percent of people polled out of 623 registered voters indicated that they favor Herbert's plan over simply doing nothing to expand health care coverage to Utahns ("Poll: Voters like guv's 'Healthy Utah Plan," June 17).

I'd like to emphasize an important aspect that should be central to the thinking in the current ongoing discussion: There are positive economic impacts in embracing the governor's solution to expanding health care coverage in Utah.

Herbert's plan, "Healthy Utah," is a three-year pilot program that uses a federal block grant to help adults ages 19 to 64 who are living below of the federal poverty level purchase private health insurance.

Healthy Utah will provide coverage to 111,000 currently uninsured Utahns, including 57,000 adults living between 100 percent and 133 percent of the federal poverty level and 54,000 adults who are living below 100 percent of the federal poverty level. The amount of assistance people could receive depends on four factors: ability to work; household income; access to employer or family health insurance; and individual health care needs. An opportunity for health care coverage could be life-altering for these people —our neighbors, our children's classmates, our community members.

With Healthy Utah, adults with access to employer-sponsored insurance or insurance through their parents' plans will receive premium assistance to enroll in those plans. Adults without insurance options will receive premium assistance to purchase insurance through Utah's health insurance exchange, Avenue H. And the medically frail will be able to either enroll in Healthy Utah or receive traditional Medicaid benefits through Medicaid Accountable Care Organizations.

If approved, Healthy Utah will cost about $258 million per year over three years — money which all comes from federal coffers. This is among the biggest selling points for me as a business owner.

When the U.S. Supreme Court upheld the constitutionality of Obamacare in 2012, they also held that states should have the right to decide what, if anything, to do about Medicaid expansion. To incentivize individual state expansion, the federal government sweetened the deal. If states opt for "full" expansion to 138 percent of the federal poverty level, which would fill in the gap, the federal government covers all of the expansion costs for three years and then 90 percent thereafter. This opportunity — to increase federal support of state Medicaid programs from 70 percent to 100 percent — is why so many traditionally conservative states like Arizona, New Mexico and North Dakota have opted for full expansion despite strong opposition against Obamacare.

There's no doubt about it — taxpayers, including business owners like myself — will be funding Medicaid expansion in the U.S. But here's an important note for Utahns: We will be funding Medicaid expansion in the U.S. even if we don't embrace Herbert's current proposal. No matter what Utah decides, Utahns will pay $6.4 billion over the next decade in federal taxes to support Medicaid expansion around the country. We can "opt out" of Medicaid expansion, but we cannot "opt out" of these taxes. So why not let our state benefit from what subsidized health care can provide in our communities?

Our state has an important decision to make and we should make it together. This decision financially impacts our state — directly, in terms of federal and state funds, and indirectly, in terms of the consequences of access to health care. Given our choices, embracing Herbert's Healthy Utah proposal makes sense.

Mark Miller is CEO of Mark Miller Auto Group and sits on the Community Board of Directors for University of Utah Hospitals and Clinics.