Utah insurance commissioner Neal GoochQ: What challenges do you anticipate your particular state running into with upcoming health care reform provisions?

NG: In Utah, our challenge is to continue implementing our state-originated health care reforms and coordinating them with the reforms the federal government has imposed. Utah forsaw the need for a health insurance exchange two years, before the Affordable Care Act was passed. Continuing the implementation of the exchange and making adjustments to include federally imposed reforms will be a challenge. Even the ACA will not address the rising cost of health care, and until that issue is fully addressed, access to affordable health care will continue to be a problem not only in Utah, but throughout the nation, as well.

Q: For producers licensed to sell health insurance in your state, what developments might they look out for?

NG: Agents are, or should be, the experts on health insurance products that address the needs of individuals, employees, and employers. Agents will need to focus on service to their clients and help them navigate the exchanges and many products that will be developed and available in the exchanges. I support the NAIC EX Subgroup that will work with Secretary [Kathleen] Sebelius to find a way to accommodate producer compensation in the MLR standards as a way to ensure that quality products reach the consumer.

Q: What should producers concentrate on the most over the next 10 years with regard to health care reform’s affects in Utah?

NG: Producers need to work with their state legislatures and the U.S. Congress to continue the regulation of insurance by state regulators. Adjustments in state legislation must be made in order to have a more uniform system, as well as to fix issues in the Affordable Care Act. Local markets must be maintained and regulated on a level playing field for all. Agents should position themselves to be the professional experts on health insurance, both to the individual and to employers.

Q: Is your state doing anything differently or preparing in any special way for health care reform?

NG: Health care reform in Utah is market-based. Utah’s approach is to ensure that the market is competitive and provides health insurance products available on the Utah Health Insurance Exchange. We currently have about 4,000 lives in the small-group market that will use the exchange as their vehicle to select products that match their needs.

Neal Gooch was appointed acting insurance commissioner on Jan. 19, 2010 by Gov. Gary R. Herbert and confirmed by the Utah Senate as commissioner on May 24, 2010. Beginning in 1986 while serving in the Attorney General’s Office, he was made general counsel to the insurance department. He served in that capacity until August 1997, when he was appointed by Commissioner Merwin U. Stewart as deputy commissioner. He was asked to continue in that capacity by Commissioner D. Kent Michie in 2005.

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Utah Facts At-A-Glance

Utah

United States

Demographics

Total population

2,770,700

303,343,300

Median annual income

$58,722

$49.945

Health costs and budget

Health spending per capita

$3,972

$5,283 (by state of residence)

Average employee contribution for family premium (% of total premium)

25%

27%

Health coverage

Uninsured population (% of total population)

14%

17%

Uninsured children (% of children)

11%

10%

Medicaid enrollment (% of total population)

11%

19%

Medicare enrollment (% of total population)

10%

15%

Monthly CHIP enrollment, June 2009

41,468

4,966,030

Health status

Infant mortality rate (per 1,000 live births)

5.0

6.8

Teen death rate (per 100,000 population)

59

62

AIDS diagnosis rate (per 100,000 population)

2.7

12.3

Overweight or obese children (% of children)

23.1%

31.6%

Adults who visited the dentist/clinic (% of adults)

72.7%

71.3%

Adults with disabilities (% of adults)

8.9%

12.1%

Source: Kaiser Family Foundation State Health Facts