5 Things Utah: 2019 health legislation, ACA timeline, balanced billing

Welcome to our inaugural edition of 5 Things We’re Watching in Utah health care and health policy. This market and policy intelligence newsletter is free and is distributed once a month. We’ll feature five things we think are worth keeping an eye on, with links to curated and original content published at StateofReform.com.

These may not be the most important things to track today in Utah health care, but we think they are worth knowing something about.  As you read us in the next few months, let me know what you think. We’re always looking for your feedback.

DJ 5 Things Signature

With help from Sara Gentzler, Marjie High
and Emily Boerger


1. Tracking 2019 health legislation

The Utah Health and Human Services Interim Committee held seven meetings during the interim to discuss health issues impacting Utah and potential pieces of legislation for the upcoming 2019 Legislative Session. With session just over a month away, the interim committee has recommended 10 pieces of legislation, covering a broad range of health-related topics.

In this piece, we provide a rundown of some of the recommended bills that caught our eye. Among several topics, the bills cover opioids, suicide prevention, firearm safety, Medicaid amendments, and mental health.


2.  The timeline for deciding the ACA ruling

Friday’s decision invalidating the ACA drew two responses: one that claimed victory, and one that said nothing has changed as this ruling will get overturned. Here’s what I think we know about this process based on the 2012 NFIB v. Sebelius case, which was the landmark ruling on the ACA.

First, the timeline for a decision will be some time, but not that long.  Marjie High and Sara Gentzler on our team researched this question and estimate a decision possibly as soon as June 2020. Like 2012, that would be like setting off a bomb in the middle of the presidential (and Utah gubernatorial) election. It’s also a fool’s errand to suggest anyone knows how the Supreme Court will ultimately decide this. No one foresaw the Roberts decision in NFIB in 2012 – I was wildly off the mark – and few will probably predict (correctly) how this court will react in 2020.


3. Balanced billing legislation in 2019

Last week’s hearing on the issue of balance billing foreshadowed a potentially emotional showdown in the legislature. Rep. Jim Dunnigan is preparing legislation to eliminate balance billing, potentially tying any out of network charges to a percentage of Medicare.  No bill yet appears on the list of pre-filed bills for the 2019 session.

Dunnigan said during the hearing that the bill is not yet finalized, but that it could be forestalled altogether if a recent contract dispute between Regence and Intermountain Healthcare could get resolved. Alan Dayton, representing IHC, said a deal was close and that Rep. Dunnigan deserved some of the credit. Dayton: “All I can do is pledge to you that we are working with Regence very hard and my understanding is we are very close to an agreement. We think some of that success is due to you, Rep. Dunnigan, and the pressure you’ve put on both companies. So, we thank you for that.”

4.  Health priorities in Gov. Herbert’s budget

Earlier this month, Governor Gary Herbert released his $19 billion budget proposal for Fiscal Year 2020. Among the budget’s priorities, which include education and tax modernization, are several health-related budget items of interest.

The Governor’s budget includes $842 million in federal funds and $135 million in state funds for Medicaid expansion, as well as $5 million for the implementation of the Utah Medical Cannabis Act. Also highlighted in the budget is funding for affordable housing, services for individuals with disabilities, and behavioral and physical health integration.


5.  Utah fifth-healthiest state in the nation, according to national report

Utah earned a fifth-place overall ranking in the America’s Health Rankings 2018 report that details health determinants and outcomes across the country. The state has claimed a spot in the top 8 each year since 1990, and fell one spot compared to last year’s report.

Based off the report’s five measured categories, Utah’s rankings vary widely. It ranked highly in behaviors (1st), health outcomes (4th), community/environment (11th), and clinical care (15th). Policy, where Utah ranked 37th, was the state’s worst overall category in terms of performance. The full data set for Utah is summarized here.