First Dual-Model Health Exchange to Debut in Utah

The federal government has granted approval to Utah for a first-of-its-kind health exchange system in which two separate exchanges will operate independently.

by / May 14, 2013

An effort by Utah -- to continue to run its small business health insurance marketplace alongside a yet-to-be-created individual health insurance exchange -- has been given the green light by the federal government. According to a report on NPR, Utah Gov. Gary Herbert made the initial request in February, which was followed by months of negotiations. A letter sent to Gov. Herbert May 10 announced the approval of the arrangement. 

"They've granted us everything that we asked for, and for that I'm grateful," Herbert said in a call with the media on May 10, praising Health and Human Services (HHS) Secretary Kathleen Sebelius for her flexibility in the negotiation process. Other states can consider a similar set-up once the HHS officially approves the rule change for Utah.

What sets the system in Utah apart is that the two exchanges will operate independently of one another. This arrangement means, for example, that the state will not provide information about participating residents and businesses for inclusion in federal databases. It is unclear at this point how Utah consumers will be able to compare plans available under each exchange when deciding on coverage.

Until now, states have selected from one of three options in implementing the exchanges, which are being set up in accordance with the Affordable Care Act, which takes effect in January 2014. Seven states have chosen federal/state partnerships, in which the two levels of government work together. State-run health insurance exchanges are being established by 17 states, while 26 states will default to an entirely federally run program for their residents.

Photo from Shutterstock

Platforms & Programs