The talks are aimed at killing legislative challenges to IHC's dominance and tax-exempt status, including Sen. Chris Buttars' bill to let patients, not health plans, choose what doctors and hospitals they use. Buttars met Monday and Wednesday with CEO Bill Nelson and Charles Sorenson, IHC's chief operating officer, and another sit-down is planned Friday, the West Jordan Republican lawmaker said. Also attending Monday's meeting were Rep. Becky Lockhart, R-Provo, and Sen. Curt Bramble, R-Provo, who sits on IHC's fiduciary board.
"IHC came to us and said, 'What would we have to do to calm the legislative waters?' " Buttars told The Salt Lake Tribune. "There were no concrete decisions or offers, but I believe you will see some major movement to defuse these problems."
IHC spokesman Daron Cowley insisted the conglomerate has no plans to sell its insurance business. He called the meetings "part of the listening process" and "a chance to find out what lawmakers are thinking."
Another way to gauge their thinking is to look at the support behind Buttars' legislation and another bill, sponsored by Sen. Michael Waddoups, R-Taylorsville. Buttars' proposal would allow patients to visit any doctor or hospital that agrees to accept 95 percent of what in-network providers receive. Waddoups' bill, which was cleared for public hearing on Wednesday, would require IHC to pay a 1.5 percent tax on gross revenue. Both bills have 14 co-sponsors, one shy of the number of votes needed to pass the Senate.
They are part of an IHC backlash that has been building for years. IHC owns more hospitals (19) and insures more Utahns (450,000) than any other health care company, and, like other HMOs, limits access to its doctors and facilities.
The company also leases its network of doctors to other insurance companies, further restricting patient choice. And that, insists Buttars, isn't healthy.
Opponents say both bills will increase insurance premiums because, without guaranteed access to patients, doctors and hospitals have no incentive to negotiate discounts. And they appear to have persuaded the legislative fiscal analyst, who, according to Buttars, was about to attach a multimillion-dollar price tag to the bill. So the lawmaker is amending it to exclude state programs that provide health benefits to low-income, uninsured families.
"My big problem with these people is that they have too damn much power," Buttars said of IHC. "They are able to move the market at will while everyone else stands around the table waiting for the crumbs."
But divorcing IHC Health Plans from the rest of the network won't remedy the problem of access, according to physicians' groups. The new company could still contract with IHC's network and exclude patients insured through other plans. And all insurance companies would still be able to charge more for out-of-network services.
"It doesn't change anything for the patient," said Marc Mariani, president of the Utah Society of Orthopedic Surgeons.
Debbie Don of the Utah Federation of Physicians and Dentists worries that lawmakers will view IHC's willingness to negotiate as a victory and abandon the legislation they have fought so long for.
"Dropping [Buttars'] bill on a promise and a handshake from IHC is not a prudent thing to do," Don said. "Patient access is not just an IHC issue."
lfantin@sltrib.com
