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Utah succeeds at reviving child-only health insurance

Published October 25, 2012 2:10 pm

Health law • Federal study lauds the measures state took to help insurers' follow the new rules.
This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Utah is among 22 states that get high marks for taking action to help insurers comply with federal health reform.

Starting in September 2010, the Affordable Care Act required insurance companies to cover all children, including those with pre-existing medical conditions. But fearing adverse selection – families waiting to enroll their kids until they fall ill – Utah's largest carriers stopped selling child-only policies, a valuable option for parents who can't afford to cover themselves.

Utah was among nine states that responded by requiring insurers to offer child-only plans. To cushion the blow, the Utah Department of Insurance also issued an emergency rule limiting enrollment to two sign-up periods annually.

As a result, Utah insurers started refusing healthy kids, arguing they were legally bound to treat all kids the same.

So Utah regulators agreed to shield insurers from the risk altogether, funneling sick children into government-subsidized insurance pools of last resort, and sending healthy children back to insurers with certificates of insurability.

It worked. Child-only coverage is now available in Utah, and 21 other states with similar – or more stringent – rules, according to a study by the Commonwealth Fund.

The findings underscore the importance of regulatory tools to avoid market disruptions, the authors say, including government subsidies to make insurance more affordable and the health law's requirement in 2014 that people have insurance.

In some states child-only policies comprise 10 percent of policies sold on the individual market, says the Commonwealth Fund.

Such numbers are hard to come by for Utah. But the state has issued 313 certificates of insurability to kids and welcomed 200 to the state's high risk pools since Feb. 1, 2011, said Tomi Ossana, who oversees the pools.

kstewart@sltrib.com

Twitter: @kirstendstewart —

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