What you missed from the most recent Utah Health Reform Task Force meeting

The most recent meeting of the Health Reform Task Force occurred Wednesday, November 13th. The interim committee, which is co-chaired by Sen. Allen M. Christensen, and Rep. James A. Dunnigan, discussed a wide range of issues during the meeting. 

On the agenda was an update on Utah’s 2020 marketplace premiums, the new transparency requirements surrounding prescription drug prices, a Medicaid expansion update, and an update on the status of telehealth in the state. The committee heard from state and market officials. 

The following were some of the main takeaways from yesterday’s meeting. 

The Department of Insurance reported on the rates of individual and small group enrollment into the marketplace. The individual market had an average rate decrease of 1.8%. This rate varied a bit by plan. The silver’s had the largest rate of decrease. But, for the most part, the rate of decrease was fairly consistent among all the plans. 

Carriers on the other hand, showed a wide variety of change. Some carriers who were attempting to become more competitive in the marketplace  had a decrease of nearly 10%.

The individual market is heavily enrolled in the bronze and silver market, mostly because most of the consumers are looking for a premium tax credit and a low cost plan. Most consumers are going to the exchange to get their coverage. 

The small group market had about a 2% rate increase, and there was not as much variance in the carriers in this category. The platinum plan had the largest increase when looking at the changes by metal level. 


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The Utah Health Department also presented on the status of Medicaid expansion in the state. The department explained where the state currently is in terms of the 1115 waiver, and what is to be expected in the coming months. 

Utah is currently operating under the Bridge Plan, and is moving forward on this portion of SB 96. The department is working to implement the last couple of provisions from this legislation which include the community engagement requirement, and the employer sponsored portion of the Bridge Plan. These will become effective January 1. 

Public comment for Phase 3 of SB 96, the Fallback Plan, closed on October 27th, where the department received 99 individual comments. The final product was submitted to CMS on the 1st of November. Interesting because of the quick turnaround, CMS typically takes 15 days to notify the department of the completion of the submission. The department received this completion notice on the 7th of November. All transparency requirements have been met according to this letter. 

The federal public comment phase for the Fallback Plan waiver is currently in place, and this segment of public commentary will end on December 7th at 11 pm. 

There was one modification to the plan based on public comment. For the poverty group from 101-138% FPL, there is a $25 copay on non-emergency medical services. This same group will also be subject to a premium since they are used to paying premiums in the marketplace currently. This $25 charge will be added as a $10 surcharge to the premium in the new plan.

The next and final Health Reform Task Force meeting will be on December 17th, at 1:00 pm, where the task force will discuss updates to Medicaid expansion and other topics before the start of the new legislative session.