This is an archived article that was published on sltrib.com in 2008, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Health-care reform in Utah will have to wait.
On Friday, the House unanimously passed a bill that calls for a legislative task force to develop a reform plan by November. HB133 now moves to the Senate.
Earlier versions of the bill - which were abandoned before it was widely released - would have mandated Utahns have health insurance by 2010 and called for new insurance plans to cover all comers without charging higher premiums based on medical history. And it would have taxed hospitals to generate $300 million in state and federal funds to help the poor buy private insurance.
But conservative lawmakers recoiled at the mandates. And the Utah Health Insurance Association balked, saying the earlier versions focused too much on providing access instead of cutting wasteful spending first.
Even before the House voted Friday, the bill's passage was a fait accompli. Forty-one House Republicans signed on as co-sponsors. And Gov. Jon Huntsman Jr. held a news conference to laud the bill, flanked by a roomful of Republican and Democratic lawmakers from the House and Senate, reform advocates, insurance and hospital executives and business leaders.
"What we do here as leaders in this state is always the art of the possible. . . . It isn't the art of the perfect," said Huntsman, who supports an individual mandate. The bill, he said, "in a very real way creates a framework for systemic reform going forward, make no mistake about it."
During the House floor debate, lawmaker after lawmaker stood in support of what they called an ambitious path to reform.
"We need to send a message to Washington, D.C., to get out of the health-care business and let individuals take care of it themselves," said Rep. John Dougall, R-Highland.
"Is this a perfect bill? No, it is not," said Rep. Phil Riesen, D-Holladay. "It's a good start. Is it important we begin the process of reforming health care in this state now? Absolutely."
Rep. David Clark, R-Santa Clara, said the eventual reform plan will emphasize "individual accountability" and "market-based forces." The bill's sponsor, he anticipates it will take 10 years to fully implement.
HB133 directs Huntsman's office to assist the Legislature in developing a reform plan. In creating the plan, state officials would consider allowing insurance companies to develop plans that, among other things, would be portable from job to job, could be exempt from certain state regulations, and would provide a minimum level of coverage to be cheaper than current plans.
The task force also would study several items including individual mandates, ways to end the practice of the insured paying for the uninsured through emergency hospital visits, expanding entitlement programs, the possibility of protecting doctors from liability claims if they follow to-be-determined best practices, and the possibility of taxing doctors and hospitals to subsidize private insurance for the poor.
The bill also says the new insurance plans would incorporate practices "that will sustain a viable insurance market."
"The last thing we want to do is go out and jeopardize the system we have right now," Clark said, noting 2.1 million Utahns now have insurance through their employers.
But one of the few opponents of the legislation says such protections ensure the legislation is a "no insurance company left behind" bill.
"It's just not worth doing. The emperor has no clothes," Joseph Jarvis, a doctor who recently quit as board chairman of the Utah Health Policy Project, said this week.
The project, which advocates for health care reform, supports the bill.
While health care reform advocates and business leaders had privately complained that the efforts resulted in a task force, few are willing to publicly criticize the bill.
Explaining the initial lack of Democratic co-sponsors, House Minority Leader Brad King said Democrats had been concerned about one controversial portion that Clark later amended.
It directs the state to seek a federal waiver to move some low-income children from the heavily subsidized Children's Health Insurance Program to the private market, with some subsidies to help their families pay premiums.
Low-income advocates fear that could result in worse insurance coverage for kids. The waiver will still be pursued, but Clark agreed to study the impact.
"Rep. Clark has gone out of his way to ensure the community supports this bill," said Karen Crompton, executive director for Voices for Utah Children.
HB 133 also creates a task force and requires it to makes decisions on 16 "action items," including:
* Creation of better, more comprehensive health insurance plans at a lower cost.
* Methods to decrease cost shifting from uninsured to those who are insured.
* Promotion of personal responsibility for individuals to acquire health insurance.
* Improvements to health-care quality and incentives to use best-practice protocols.
Rep. David Clark, R-Santa Clara, said his health care bill would take action now to:
* Create tax credits, worth $18 million, for people who buy their own health insurance.
* Seek ways to expand public subsidies for lower-income Utahns buying private insurance.
* Create an Office of Consumer Health Services.
* Invest in data collection and standards to help consumers make choices about their health care.
* Other related bills would help boost enrollment in government-subsidized health insurance.