Utah governor: Make our existing exchange our PPACA exchange

Although it was not designed to significantly reduce the number of uninsured in the state, there are detractors of Utah’s plan that point out that there are still about 400,000 uninsured people in Utah, or about 14 percent of the population, according to figures from the Kaiser Family Foundation.

The purpose of Gov. Herbert’s letter is to send the message that states need true flexibility to be able to run efficient state-level exchanges, said Norman Thurston, health reform implementation coordinator for the state of Utah.

“We have to have ownership of the programs,” Thurston said. “We have to have the ability to run them in a way that meets the needs of our populations.”

Under PPACA, every state will have an exchange starting Jan. 1, 2014. The exchanges will provide one-stop shopping for individual consumers and small businesses.

Low-income people can find out if they will qualify for coverage through Medicaid. Middle-income people can pick a private insurance plan offered through the exchanges, and in most cases, get federal government assistance to pay their premiums.

Virtually every American must have health insurance starting in 2014. At the same time, insurers will be forbidden from turning down people in poor health or charging consumers more because of a pre-existing condition. The law also limits what insurers can charge older customers, who are more prone to health problems.

States have three options as far as exchanges. They can build their own, they can run one in partnership with the federal government, or they can default to Washington and let the feds set up and operate their exchange.

So far, 16 states and the District of Columbia have said they will set up their own exchanges, while 19 Republican-led states have opted to allow the federal government in. Another seven states have picked the partnership model, and the rest are trying to decide. States that want to run their own exchanges have until Friday to submit plans, but the deadline for partnership applications isn’t until February.

A recent AP poll found that Americans prefer that states have a strong hand in running the exchanges. Sixty-three percent said states should run the new markets, while 32 percent preferred federal control. Republicans heavily favored state control.

This is the second letter sent by Herbert to federal officials regarding his state’s health insurance exchange. In November, Herbert wrote to Health and Human Services Secretary Kathleen Sebelius asking for help with “far too many unanswered questions” about the federal alternative.

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Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.