Hmm: Utah’s existing health exchange gets conditional nod from feds

posted at 8:31 pm on January 3, 2013 by Mary Katharine Ham

It’s hard to tell exactly what this means yet, but it’s a flashpoint to watch as the federal government works to create health care exchanges in more than half of the states— a task it foolishly didn’t think it would have to do and is now worried it can’t finish by the scheduled opening of exchanges in October.

Utah has been operating an exchange for three years for small businesses, but that marketplace allows for plans with minimal coverage and catastrophic options, and generally defies all the heavy-handed regulations Obamacare enacted. Because it existed before Obamacare, it doesn’t abide by a long-awaited rule that explains exactly what “Essential Health Benefits” exchange-worthy plans will have to cover under the federal guidelines. Those rules were released in November, more than two years after the bill passed, because it would have been politically unpopular to tell everyone their newly cumbersome health plans were going to cost a bunch more under the Affordable Care Act.

But now that the federal government is in a bit of a pickle, Utah figures it can maybe get its existing health exchange to count in the new system. After all, the feds don’t want to add another state to their build list. Today, the federal government conditionally approved Utah’s exchange, but with stipulations that it must “improve” it.

Utah is among the first Republican-led states to win conditional approval to run their own health exchanges.

But federal officials made clear the Beehive State’s existing insurance marketplace, Avenue H, still needs upgrading to become fully compliant with the Affordable Care Act — dashing Gov. Gary Herbert’s hopes that it might serve as a “bare minimum” standard for other states to follow…

“In all these states there’s more work to be done. But we believe they’ve made significant progress,” said Gary Cohen, deputy administrator of the department’s Center for Consumer Information and Insurance Oversight. “What we’ve said is, in order to be certified, [Utah’s exchange] needs to comply with our statute and regulations.”

Utah must submit by Feb. 1 a timeline for upgrading its 3-year-old insurance portal. The state must also show that it can fund it and that it has legal authority to set up a consumer-outreach program to help shoppers navigate their insurance options.

“We recognize that Utah is working under intense timelines and will work with you to establish benchmark dates that are appropriate and will allow us to jointly monitor Utah’s progress,” wrote HHS Secretary Kathleen Sebelius in a Thursday letter to Herbert.

It’s an open and interesting question what the legal status of the Utah exchange would be if it was not deemed in compliance. Because many of the rules for the health care law are still being written, the idea of in compliance may be subject to change. I wonder if it’d get more flexible as the federal government nears its deadlines, grappling with more than 20 state exchanges, and okaying an up-and-running exchange in Utah starts to look more attractive than building one for the state. Herbert will no doubt stay engaged in the process and angle to get as much flexibility as possible.

Other states got conditional approval today, too, including three others with Republican governors, which just means that those states kinda-sorta have a plan to create an exchange, which will theoretically plug into a federal data hub that doesn’t yet exist by October.


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Because many of the rules for the health care law are still being written,

I guess reading the bill before signing it wasn’t needed..

Electrongod on January 3, 2013 at 8:39 PM

I wonder if expertsexchange.com is the right forum for the experts working on health exchanges…

Archivarix on January 3, 2013 at 8:39 PM

This law is another one that will be ignored/resisted by millions of Americans and will go the way of Prohibition. But not before and underground medical system develops, run by the mob, and people flock to “medical speakeasies” to avoid govt. interference and invasion of privacy. Dr. Al Capone, call your Tommy Gun dealer…..

devan95 on January 3, 2013 at 8:51 PM

Other states got conditional approval today, too, including three others with Republican governors, which just means that those states kinda-sorta have a plan to create an exchange, which will theoretically plug into a federal data hub that doesn’t yet exist by October.

Mary Katharine Ham

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Federal data-hub ?
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Well, no worries here. What could possibly go wrong?

listens2glenn on January 3, 2013 at 8:52 PM

It looks bizarre, the cancer of Obama Care eating up and displacing the healthy medical infrastructure of the United States. A bunch of progressives with constructor sets, building a fantasy bridge, where real infrastructure should go.

Children can’t be allowed to run the world.

Axe on January 3, 2013 at 8:53 PM

a long-awaited rule that explains exactly what “Essential Health Benefits” exchange-worthy plans will have to cover under the federal guidelines. Those rules were released in November, more than two years after the bill passed, because it would have been politically unpopular to tell everyone their newly cumbersome health plans were going to cost a bunch more under the Affordable Care Act.

This is really the problem with Obamacare — not the mandate (since there was already a mandate that hospitals had to give poor people free care). The “minimum” requirements demanded by the states — and now the federal government — are what drive up costs and introduce moral hazard. It’s really a similar problem to the minimum wage.

Count to 10 on January 3, 2013 at 8:54 PM

This law is another one that will be ignored/resisted by millions of Americans and will go the way of Prohibition. But not before and underground medical system develops, run by the mob, and people flock to “medical speakeasies” to avoid govt. interference and invasion of privacy. Dr. Al Capone, call your Tommy Gun dealer…..

devan95 on January 3, 2013 at 8:51 PM

That’s an ugly thought, and I can’t say that it wont happen.

Count to 10 on January 3, 2013 at 8:56 PM

Michele Bachmann introduces Obamacare repeal bill, libs freak out –

http://twitchy.com/2013/01/03/michele-bachmann-introduces-obamacare-repeal-bill-libs-freak-out/

Pork-Chop on January 3, 2013 at 9:12 PM

Children can’t be allowed to run the world.

Axe on January 3, 2013 at 8:53 PM

The constituents of whom are euphemistically called low-information voters.

Drained Brain on January 3, 2013 at 9:16 PM

Michele Bachmann introduces Obamacare repeal bill, libs freak out –

http://twitchy.com/2013/01/03/michele-bachmann-introduces-obamacare-repeal-bill-libs-freak-out/

Pork-Chop on January 3, 2013 at 9:12 PM

Cruz is doing it too in the Senate.

gophergirl on January 3, 2013 at 9:27 PM

That’s an ugly thought, and I can’t say that it wont happen.

Count to 10 on January 3, 2013 at 8:56 PM

It MIGHT, but I personally doubt it, because the mob is d@mn-near braindead when it comes to selling something that doesn’t involve death or violence, be it directly caused (like murder for hire) or indirectly (like drugs).

Or in other words, the hell-spawned scum have spent generations refining the art of harming…but they would have not a single clue where to start running a ‘business’ where the business was to make people better and they know it. The closest they’ve come is running soup kitchens.

They’ll probably try smuggling material to ‘underground hospitals’. Good luck getting anything from them that isn’t contaminated and/or counterfeit.

MelonCollie on January 3, 2013 at 9:43 PM

plug into a federal data hub that doesn’t yet exist by October

Next you’re going to say you don’t believe in Unicorns.

Hater.

CorporatePiggy on January 3, 2013 at 9:49 PM

Today, the federal government conditionally approved Utah’s exchange, but with stipulations that it must “improve” it.

There’s no “hmmmm” here – it is the same play as the “compromise” that religious organizations get an extra year to jettison their principles.

Steve Eggleston on January 3, 2013 at 9:54 PM

Michele Bachmann introduces Obamacare repeal bill, libs freak out –

http://twitchy.com/2013/01/03/michele-bachmann-introduces-obamacare-repeal-bill-libs-freak-out/

Pork-Chop on January 3, 2013 at 9:12 PM

.
Cruz is doing it too in the Senate.

gophergirl on January 3, 2013 at 9:27 PM

.
Wow … I rarely go to any website that has that kind of “hate”, but I followed the link and . . . . . . . . . . . I can’t come up with the words to describe that in all sobriety. Just can’t.

listens2glenn on January 3, 2013 at 10:00 PM

Wow … I rarely go to any website that has that kind of “hate”, but I followed the link and . . . . . . . . . . . I can’t come up with the words to describe that in all sobriety. Just can’t.

listens2glenn on January 3, 2013 at 10:00 PM

Go here and remember who you are, my gentle bud. :)

Axe on January 3, 2013 at 10:06 PM

My legislature will be going into its annual session soon. I expect a bill suggesting something along the lines of the conversation between Boehner and Reid.

SaintGeorgeGentile on January 3, 2013 at 10:07 PM

It’s time to call Time on writing any more rules.

States like Utah ought to start petitioning to have their rules added to the big 3000 pages, so they can do as they always have done.

And also, I would like a single issue bill to come out of the house, that says, that everyone is entitled to satisfy the demand to participate in the Affordable Health care act, by having their own, continuing, health savings account, that they can choose to spend on insurance or doctor visits of their choice or Otc health care.

The burden is the federal government micro managing, writing rules, spending money, and no one feels healthier, just more stressed out.

Fleuries on January 3, 2013 at 10:07 PM

My medical speakeasy is Nogales Mexico. But they keep tightening the border. Not for illegals, of course. But for guys like me that need a script like colchicine that is $10/30 there and $176/20 here. Used to be $10 here. Till barky got elected.

Screw any exchange. I could get a pot script easier than a non-narcotic medicine that’s been around since the egyptions that I really need. Barkys stupid ideas have already caused me a lot of pain, physical and financial.

I go off grid just to spite them, now.

wolly4321 on January 3, 2013 at 10:09 PM

And I had health insurance until barky got elected, work stalled to a crawl, and my premiums over doubled.

wolly4321 on January 3, 2013 at 10:14 PM

listens2glenn on January 3, 2013 at 10:00 PM

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Go here and remember who you are, my gentle bud. :)

Axe on January 3, 2013 at 10:06 PM

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Yeah, that’ll work … : )

listens2glenn on January 3, 2013 at 10:28 PM

This is really the problem with Obamacare

The problem with Obamacare is that we are adding 38 million people (more than the entire Canadian population) to our existing system.
Libs don’t realize how small Canada is…and how Canadians still manage to come here when its serious.

monalisa on January 3, 2013 at 10:59 PM

“We recognize that Utah is working under intense timelines and will work with you to establish benchmark dates that are appropriate and will allow us to jointly monitor Utah’s progress,” wrote HHS Secretary Kathleen Sebelius in a Thursday letter to Herbert

…was she sitting on toughguy Rollover Orrin Hatch‘s lap…when she wrote it?

KOOLAID2 on January 3, 2013 at 11:17 PM

are what drive up costs and introduce moral hazard. It’s really a similar problem to the minimum wage.

Count to 10 on January 3, 2013 at 8:54 PM

Cept maybe, just maybe, their real goal is precisely to drive up costs and bankrupt America so the socialists can come in an save us? What has the left done that doesn’t fit this intent?

This is the classic Commie MO after all. First tear down whatever is working to destabilize the place…(Name an institution the left hasn’t corrupted:Churches, family, education, media, science(AGW) energy, business, banking, and every social structure that held us together since the beginning )
Can it all be just incompetence–or is it by intent?

Don L on January 4, 2013 at 6:25 AM