The devotion shown by Gov. Gary Herbert and other Utah political leaders to the state's poor shadow of a health insurance exchange known as Avenue H proves one thing.
The folks who run Utah are firmly opposed to doing anything that would help low-income people find health insurance for their families. Even if the federal government is paying for it. Even if helping individuals would also help many of the small businesses that Utah politicians claim to value so much.
Unable to convince President Obama and Heath and Human Services Secretary Kathleen Sebelius that Avenue H comes anywhere near meeting the requirements of the Affordable Care Act or of basic human decency Herbert now says he is willing to stand aside and allow HHS to set up a real health insurance exchange for the benefit of Utahns.
That will be good for many of our friends and neighbors. But it will put the lie to the suggestion that Utah was ever capable of running the kind of exchange that would actually benefit those most in need of the help.
Time was that the idea of an online exchange was on the cutting edge of market-based reform theory. Pioneered here, and in Gov. Mitt Romney's Massachusetts, the idea was that small businesses and individuals who were otherwise unable to find an affordable plan with decent coverage would be empowered to do so by the wide view of an Internet marketplace. It was envisioned as a free-market choice, rather than a government-imposed restriction.
But Avenue H was only intended for businesses, not for the many individuals who are self-employed or who work for employers who, exchange or no exchange, weren't interested in providing coverage. And the Herbert administration stubbornly refused to add to its exchange some of the links required by the ACA.
One of those was a filter to inform shoppers if they were eligible for either a federally subsidized health plan or for Medicaid. Herbert's refusal to add such features was pure stubbornness, as the information would not only help low-income families, but also ease the burden on their employers.
Herbert also balked at using the exchange to inform people of their obligation under the ACA to buy insurance, or find a way to have it provided for them. This despite the fact that the individual mandate began life as a conservative idea to prohibit freeloaders who would go without insurance until they needed it, then jump on the subsidized bandwagon.
Without these features, chances are that Avenue H will soon wither and die. Herbert can blame the president for that if he wants to. But it will be Utah's fault.
See more about comments here.