Utah: Where even conservatives have a history of health reform

By Tom Sullivan
08:48 AM
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Utah has a healthcare history perhaps as cragged as the mountains of Moab.

Mike Leavitt, a former governor who pushed for a health insurance exchange (HIX) in that state, has since joined Mitt Romney’s transition team – and while Romney campaigns on promises of first issuing states waivers to opt out of reform measures including the contentious HIX, then ultimately repealing the Affordable Care Act, Leavitt’s consulting firm continues to maintain contracts helping states stand up exchanges.

And, leading up the state’s primary on June 26, Leavitt is not alone among Utah politicians, past and present, whose conservative nature is under fire. A National Review piece last week asked rather bluntly: Is Orrin Hatch conservative?

[Political Malpractice: 3 ACA aspects states should keep no matter how SCOTUS rules.]

Sparking that question is Hatch’s involvement with Utah’s State Children’s Health Insurance Program, otherwise known as SCHIP.

“Two leading economists, MIT’s Jonathan Gruber and Cornell’s Kosali Simon, have found that SCHIP has crowded out private insurers. According to their data, over 60 percent of those who were privately insured before enrolling switched to public plans,” National Review’s Nathaniel Botwinick wrote in the article. “The state plans, funded with taxpayer dollars, offered more benefits than did the traditional private plans, and private insurers could not compete.”

Such twists and turns in the national spotlight, indeed, belie the state’s experience with exchanges of both stripes, those being insurance and health information exchanges (HIE).

In Utah, “we have the good fortune of having an HIE that’s been operating for 15 years,” said Marc Bennett, CEO of HealthInsight, the nonprofit AHRQ Chartered Value Exchange spanning Utah and Nevada and a founding member of the Utah Health Information Network exchange.

What all this means, in Bennett’s words, is that today, “we have the politics of the community. People know how to talk about HIE. That’s proven very valuable.”

[Political Malpractice: South Dakota, Montana push back on insurance exchanges.]

HIX and HIE. Utah began both prior to passage of the Affordable Care Act in 2010. As of January 2012, there were 19 health plans engaged with Utah’s All Payer Claims Database, comprising 2.1 million patients, or 93 percent of the commercially insured market, according to data from the Utah Department of Health.

“Public health had been a driver of our info exchange from the administration days. What it brought to the table was the providers came because, not insignificantly, Medicaid said ‘the only way you can exchange information with us is through the exchange,’” Bennett said. “The politics of public health thinking is important enough to do this and work together … we built the infrastructure to force people to come together.”

While Utah has accomplished just that, a divide remains at the national level between conservatives hopeful the health law will perish – be that in the Supreme Court ruling expected by June’s end or a would-be president Romney’s promises of repeal – and the progressives calling for the continuation of health reform measures.

And for the interest of both parties and their respective constituencies, perhaps Mike Leavitt will offer a balance, as he’s been saying lately that a free market approach to exchanges is best, after telling Politico in February that “exchanges are going to be a part of the future no matter what.”

For more of our politics coverage, visit Political Malpractice: Healthcare in the 2012 Election.