Calling the state's health care reform efforts this year a "very, very significant step forward," Gov. Jon Huntsman Jr. signed four pieces of legislation Wednesday that he says will help more Utahns get insured.
"We all knew from the beginning our state was too compassionate, too good, too smart, too creative to let 300,000-plus people go without coverage and insurance," he said. "Today is a significant step toward getting to where we all know we can be in closing that gap and taking the superfluous costs out of health care."
The bills, crafted in the second year of what lawmakers say is a decade-long plan, would create more options for affordable health insurance -- and make policies a little easier to buy.
Utahns, for instance, will soon be able to take defined contributions from their employers and buy coverage on their own. And the state is going to help them do it by creating an Internet portal through which they can shop for and compare plans. Among them will be a new, cheaper product called NetCare.
"Cost seems to be a major inhibitor," said House Speaker David Clark, R-Santa Clara. "If I'm still at the federal poverty level and if I drop something I couldn't afford at 100 percent down to 60 percent, it's probably still unaffordable. So we have much more work to still do."
Collectively, Huntsman said, the bills improve the affordability, accessibility and portability of policies, and make the market more transparent.
"There isn't another state in America that wouldn't want to trade places with where we are with this legislation," he said. "These four pieces really do put us at the forefront of health system reform."
The largest of the four bills, HB 188, has two major parts: first, it creates NetCare, a plan insurers will be able to offer at a third to half the cost of the average large-group premium. Rep. Jim Dunnigan, R-Taylorsville, says the savings come not only from allowing the exclusion of some mandated care, such as diabetes management, but also from building in wellness incentives, setting higher deductibles and placing caps on preventive care.
Employers would be authorized to offer NetCare as an alternative to COBRA and as an option for helping people transition from group coverage to the individual market.
Second, HB 188 allows small employers to give workers the option of picking between the plan the employer chooses or to take the employer's contribution and buy insurance on their own.
Employees who purchase insurance this way would have more protection than the individual market affords. Companies will be able to vet applicants based only on their age, where they live and the composition of their family -- not their medical history.
In return, insurers will be protected from a spike in expensive claims by assistance from the Utah Health Re-Insurance Pool, a nonprofit that will be created within the state's Department of Insurance.
Clark said the Legislature's Health System Reform Task Force will next tackle the issues of cost and quality.
He said building up the state's primary care physician work force, promoting and building on the "medical home" concept, exploring best practices in medicine and investing in electronic medical records all fall under that umbrella.
Another major imperative will be forming partnerships with the federal government to remove obstacles to state reform efforts.
"We're finding our ability to do things is greatly, greatly inhibited by the ERISA law, the HIPPA law, the federal labor laws, the federal IRS codes --- all of those things," Clark said.
Other health care bills signed into law include
SB 79, Medical Malpractice Amendments » Increases the level of evidence plaintiffs must show from "preponderance of evidence," to "clear and convincing evidence" for emergency room-related malpractice claims. It also tightens the state's licensing laws to increase oversight of out-of-state medical expert witnesses. Its sponsor, Sen. Peter Knudson, R-Brigham City, said the bill opens "a wider door" for physicians to practice emergency medicine, since many were reluctant to do so because of potential liability issues.
HB 165, Administrative Simplification » Amends the way hospitals and health care providers send bills to patients, creates a demonstration project for innovation in payment and delivery of health care, and moves Utah toward the use of standardized swipe card technology for insurance cards so patients and providers can get real-time information about deductibles, co-payments and insurance status.
HB 331, Health Insurance Coverage in State Contracts » Requires general contractors who contract with certain state departments and public transit districts for a construction project worth $1.5 million or more -- and subcontractors for projects worth $750,000 or more -- to provide a basic level of health insurance for their employees. Its sponsor, Rep. Jim Dunnigan, R-Taylorsville, said the legislation levels the playing field for contractors bidding on state projects and helps control the cost shifting that occurs between uninsured and insured Utahns.
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