Full Citation
Title: The Basic Health Program in Utah
Citation Type: Miscellaneous
Publication Year: 2012
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Abstract: Using the American Community Survey augmented with results from the Urban Institutes Health Insurance Policy Simulation Model (HIPSM), we estimated eligibility, enrollment, and costs for a Basic Health Program (BHP) for Utah under the rules defined in the Patient Protection and Affordable Care Act (ACA). Important findings include these: 55,000 Utahns would qualify for BHP; between 31,000 and 41,000 would likely enroll, if BHP is structured like the states current CHIP program. We were able to break results out by substate areas. For example, we estimate BHP enrollment of 9,500 in western Salt Lake County and 6,100 in eastern Salt Lake County. For low-wage, working Utahns, BHP could substantially reduce the cost of health coverage and care, compared to the exchange with standard federal subsidies. With member cost sharing based on CHIP B, federal BHP payments would exceed state BHP costs by $300 per member per year. With the higher cost sharing of CHIP C, they would exceed costs by $1,100 per member. The surplus of federal payments over costs could be used to raise provider payments or lower member cost sharing. Applied entirely to provider reimbursement, the surplus could raise payments 8 percent over Medicaid levels if members receive CHIP B-level coverage or 27 percent if members receive coverage modeled after CHIP C. Even with BHP, the health insurance exchange in Utah would cover about 120,000 lives in the non-group market, down from about 160,000 without BHP. BHP-eligible adults are slightly healthier, on average, than others projected to receive non-group coverage under the ACA. Removing BHP adults from the exchange would thus increase non-group premiums by less than 2 percent. That increase could be avoided by including BHP in the same risk-sharing systems that apply to non-group plans. Administering Washington States Basic Health program took up 4 percent of total costs when it was run as a separate state program. There may be opportunities under the ACA to reduce these costs by integration with Medicaid managed care and the exchange.
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Authors: Roth, Jeremy; Buettgens, Matthew; Carroll, Caitlin; Dorn, Stan
Publisher: Health Policy Center - The Urban Institute
Data Collections: IPUMS USA
Topics: Health
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