But many Utahns can't, forcing them to become uninsured, said Rep. Jim Dunnigan, R-Taylorsville. That's why the state's health insurance carriers are coalescing around a new plan called Net Care that is designed to be a more affordable alternative.
Offered at one-third of the price of the average large-group plan, Net Care would be available to people coming off their employer plans for up 12 months, to help them transition to new coverage, Dunnigan told the Legislature's Health System Reform Task Force on Thursday at its monthly meeting.
In its conceptual stage, Net Care is just one idea being offered by insurers to whittle down the number of Utah's uninsured.
"Right now there are products available in the individual market and I would certainly classify them as affordable," said Dunnigan, an independent insurance broker, but "we also recognize there is underwriting (evaluation of applicants) involved and people may not qualify."
The Net Care plan would be a leaner version of the employers' plan, covering a person's first four office visits except for a $20 co-pay. From his or her fifth visit forward, a $2,000 to $2,300 deductible would kick in, though preventative care would continue to be covered.
The insurance plan would be guarantee issue, meaning a person's health history would not be taken into account when he or she applies for coverage. And unlike COBRA, which requires a person at a small company to have worked for his or her employer a minimum of six months, Net Care would only require three.
"We think we'll be able to capture some of those who are choosing to go bare, or at least for a period of time," said Dunnigan, who presented the plan on behalf of the task force's insurers work group.
But Rep. David Litvack, D-Salt Lake City, and others questioned whether Net Care would compromise access to care in order to be more affordable insurance. He pointed to the state's Primary Care Network, a plan that covers primary and preventative care, but little else.
"I kind of hear tweaking around the edges of the current health system," he said. "I'm not hearing in a lot of this discussion how we address comprehensive reform."
Dunnigan said the more comprehensive coverage a plan offers, the more expensive it will be. However, zeroing in on wellness program incentives - something the task force heard presentations on Thursday - could be one route to lowering health care costs, making it possible to offer the comprehensive, affordable health plans consumers want to see.
"Personal responsibility - that's where the big dollar savings come from," he said.
lrosetta@sltrib.com
The Consolidated Omnibus Budget Reconciliation Act is a federal law under which employers must offer continuing insurance coverage to departing employees in certain circumstances. During the temporary coverage, workers usually must pay the full policy premium without a subsidy formerly paid by the employer.
