HEALTH CARE

Health System Reform

Legislators set in motion a reformation of the healthcare system that could contain health care costs, improve quality, and provide universal insurance coverage. HB 133, Health System Reform, by Rep. David Clark, creates a task force to create this bold pathway to major reform. This effort would essentially let the market — providers, insurance carriers, and consumers — share the burden of reform.

HHS Secretary Michael Leavitt has challenged the state to come up with a reformation plan. While he is still in office, the state may be able to rely on the federal government to ease the implementation of the reforms.

Specifially, HB 133:

·         Creates an Office of Consumer Health Services under the control of GOED, not to regulate but to call on the private sector to develop individual, affordable policies that never have been available

·         Calls for the implementation of the state's strategic plan for health system reform

·         Requires the Insurance Department and the Department of Workforce Services to participate in the development of the state's strategic plan for health system reform and to work with insurers to develop standards for health insurance applications and standards for compatible systems of electronic submission of applications

·         Calls for allowing individuals and self-insured business owners who pay for insurance after taxes to receive a tax credit (approved in a separate bill, HB 359, Tax Changes, By Rep. John Dougall)

·         Requires the Insurance Department to facilitate a private sector method of collection of premium payments from multiple sources and to encourage health insurers to develop new health insurance products that meet certain criteria

·         Changes the threshold at which an individual qualifies for the state's Comprehensive Health Insurance Pool

·         Changes the eligibility for the individual market so that if Utah's Premium Partnership for Health Insurance may be used to help purchase an individual policy

·         Requires GOED to serve as the coordinating entity to work with the executive branch agencies, and to report to and assist the Legislature with the state's strategic plan for health system reform

·         Describes the state's strategic plan for health system reform and the time line for implementing the strategic plan

·         Establishes the Health System Reform Legislative Task Force to develop and implement the state's strategic plan for health system reform

·         Requires the task force to evaluate and make suggestions to change the system, including:

-        market-driven health care that transfers choice and purchasing power to consumers

-        making insurers and providers more responsive to consumer needs and preferences

-        providing for a system of consumer-based medical records and publicly accessible information about health-care prices and performance of providers and insurers

-        risk adjustments that provide insurers and providers greater payment for serving the very sick

-        the development of one or more new insurance products

The health care tax credit would cost $18.7 million and would allow 70,000 Utah taxpayers who buy their own health insurance to pay their insurance premiums with "pre-tax" dollars. This could save those people between $100 and $500 per year.

About $10 million next year and $14 million in 2010 was approved for CHIP, the joint state/federal insurance plan for children in families with working parents who don't have insurance benefits through their workplace. The money is intended to keep enrollment open, which has been closed more often than not the past five years.

The Chamber also endorsed HB 47, Standards for Electronic Exchange of Clinical Health Information, by Rep. Ronda Menlove. It passed as part of the legislature’s overall health system reform effort. The bill authorizes the Department of Health to adopt standards for the electronic exchange of clinical health information to require individuals who elect to participate in an electronic exchange of clinical health information to use the standards adopted by the department.

HB 326, Children's Health Insurance Program - Open Enrollment, by Rep. Greg Curtis, also passed. It requires the Department of Health to keep enrollment in CHIP open so that an eligible child who applies for coverage under CHIP can enroll in the program.