The Affordable Care Act promises to extend the reach of health care coverage to many people who don’t have it now. Critics say it will do that at a huge cost in both money and individual liberty. But the mandate in the law for nearly everyone to buy health insurance has been upheld by the U-S Supreme Court and that requirement will take effect in 2014. The question facing Utah and the rest of country is how to implement the provisions that are maintained by the states.
Utah Foundation researcher Morgan Lyon Cotti says the Affordable Care Act will include elements of different health care models from around the world.
“The way that we treat veterans is very similar to what Great Britain does,” Cotti tells KUER. “The way that we treat those in poverty is very similar to what countries like Germany and France do. And so, even with the Affordable Care Act, even if states were implementing it more consistently, we would still have the different elements.”
The state of Utah was among the first to implement an insurance exchange for small business, and it’s taken other steps toward health care reform on its own. But the Affordable Care Act also calls for a big expansion of Medicaid, the joint state and federal health care program for the poor. Utah Governor Gary Herbert says it’s not just a question of waiting for the election to decide whether to cooperate with the federal effort. He says the state won’t know what to do until it gets some answers from the U-S Department of Health and Human Services.
“What happens with our exchange,” Herbert asked in his monthly news conference on KUED. “Can we get more flexibility? Can we get block granting of money as opposed to having to follow the national monument mandate, which doesn’t work for us in Utah as a one-size-fits-all approach. So there’s a lot of questions that need to be answered.”
While Utah’s largest health care system hasn’t taken a position on the expansion of Medicaid, a vice-president of Intermountain Healthcare says it could have some benefit. Mikelle Moore says getting people the right care when they need it benefits everyone.
“We’ve seen that when people feel they have access to care that they can afford that they are more likely to get the care that they need in an appropriate setting,” Moore told KUER in an interview earlier this year. “That means they have access to well exams, access to urgent care and don’t perceive that they can only access care when they’re in an emergent situation. So I do think when people transition from uninsured to Medicaid that they can experience improvements in health. In addition, Medicaid coverage allows for hospitals and providers to get paid, which reduces the burden on the rest of the system for all of us.”
But expanding Medicaid and the Affordable Care Act are among the most divisive issues in this election campaign, particularly among the active citizens who serve as delegates to Utah’s political party conventions. The Utah Foundation’s Morgan Lyon Cotti says health care is one area where the delegates who nominate candidates at political party conventions hold stronger views than the rest of Utah’s voters.
“Not surprisingly,” Cotti says,”90% of Republican delegates thought it should be repealed, compared to 75% of voters. And only 6% of Democratic delegates and 12% of Democratic voters thought it should be repealed.”