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Fixing Utah's Health Exchange

In the February issue of Governing, my colleague Josh Goodman wrote about Utah's health exchange -- a free-market alternative to the Massachusetts Commonwealth Connector. ...

In the February issue of Governing, my colleague Josh Goodman wrote about Utah's health exchange -- a free-market alternative to the Massachusetts Commonwealth Connector. Where the Connector has substantial regulatory power, the Utah Health Exchange is more like a bazaar where small businesses are invited in to browse for policies. As Josh made clear, Utah officials hope the result will be better, more affordable health insurances without big government.

While officials in Utah have high hopes for their exchange, the state's early experiences have been a bit...problematic.

Only 600 people have signed up, and some of the companies participating have been startled to find higher insurance premiums within the exchange than outside of it. Now House Speaker David Clark is stepping in. According to the Salt Lake Tribune, he's introduced legislation that will require insurers to calculate a single small business rate, as opposed to separate rates for companies inside and out of the exchange. The bill would also prevent insurers from underwriting based on certain preexisting conditions and require them to publish satisfaction measures. Finally, Clark would invite larger employers to join the pool.

Will this legislation pass, and more important still, will it work?

Meanwhile, as of February 1, 24,000 people had purchased health insurance through Massachusetts's Commonwealth Connector. Am I missing something here, or does the Connector model look a lot stronger at this point? Your feedback is welcome. In the meantime, here's a presentation from Connector executive director Jon Kingsdale on how MA's health reform works.

Update: My colleague Josh notes that Utah's exchange is seen there as something of a pilot program and that comparing it with the long-established Connector is thus somewhat unfair.
John is a Governing correspondent covering health care, public safety and urban affairs.
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