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Last call for stopgap health insurance for Utah's poor

Published May 27, 2014 7:43 pm

Health reform • Utah's Primary Care Network covers limited preventive care.
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

It's not Medicaid, but it's the next best thing.

That's been the selling point for Utah's Primary Care Network (PCN), limited coverage of preventive care for working poor adults who are ineligible for traditional Medicaid.

The program opens for enrollment on June 2 for what may be the last time. There is no deadline, but enrollment will close as available slots are filled, according to the Utah Department of Health.

Barring federal approval for an extension, the program will expire on Dec. 31, 2014.

"We don't see why they would extend it again," said RyLee Curtis, Medicaid policy analyst for the Utah Health Policy Project (UHPP), noting that the expectation is for states like Utah to, instead, expand Medicaid.

Started in 2002 as part of then-Utah Gov. Mike Leavitt's 10-year plan to reduce Utah's ranks of uninsured, PCN covers doctor visits, dental and vision care and up to four prescriptions per month — but no inpatient or specialty care.

"The fiscal picture in Utah and most other states prevented traditional expansions of Medicaid to parents and people without children. It was simply too costly and would not gain widespread political support," explained Rod Betit in a Q&A on the program, published by the Robert Wood Johnson Foundation.

The state had some funding, though, and "the policy question facing Utah was whether to wait for new federal funding to expand coverage to these low-income working adults, or to push the federal government to allow the state to offer a limited benefit plan," said Betit, Leavitt's health director at the time.

Years later, in 2010, new federal funding did materialize with President Barack Obama's health law, which pays up to 100 percent — and no less than 90 percent — of the costs to expand Medicaid.

But key Republican legislative leaders in Utah have resisted any plan to stretch the health safety net.

The feds have allowed Utah to continue PCN through the end of the year, but lowered the income-based eligibility threshold and removed the $50 enrollment fee.

The program is now open to uninsured adults who earn less than the federal poverty level, or $11,490 for a single adult. Previously it was open to those earning up to 150 percent of the poverty level.

Enrollment in PCN is capped at 25,000, which has never been reached due to funding limitations, said Kolbi Young, a health department spokeswoman. Currently 12,000 slots are filled and the enrollment target is about 20,000, she said.

kstewart@sltrib.com

Twitter: @KStewart4Trib —

Can't afford health insurance?

P Enrollment is open for Utah's Primary Care Network (PCN), limited health insurance for low-income adults. To find out if you qualify, call 1-888-222-2542 or visit http://www.health.utah.gov/pcn.