Health Insurance for Utah Children and Small Businesses

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Health Insurance for Utah Children and Small
Businesses
Expanding Health Insurance Coverage for Utahs
Uninsured Citizens

• November 15, 2006

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What is our focus and why?

• Nearly 300,000 Utahns are uninsured
• This is a problem
• A. Most of the cost of uncompensated care is
  being passed on to Utahs businesses that provide
  health benefits to their employees
• B. Uninsured people get less effective and more
  expensive health care
• Over 70,000 of the uninsured are children (0-18)
• Over 100,000 of the uninsured work for small
  businesses
• Our two primary goals
• Make sure Utah children have health insurance
• Make it easier for employees of Utah small
  businesses to get health insurance

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Who are the 11.6?

• Currently Uninsured (11.6) 292,800
• By Age
• Children, Under 19 years old (24) 71,300
• Young Adults, 19 to 34 years old (45) 132,000
• Adults, 35 years old or older (31) 91,500
• Note Figures in these categories do not sum to
  the total because of missing values on the
  grouping variable.
• By Employment Status
• Adults, 19-64 with Full-time jobs (38) 110,300
• Adults, 19-64 with Part-time jobs (14) 43,000
• Adults, 19-64 who are Self-employed (16) 46,700
• Utahs Most Likely Uninsured Person
• White male
• Between the ages of 19 and 34
• High school graduate, with no college degree
• Full time job
• Household income between 20,000 and 45,000

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Key Factors The Young Immortals

• 70 of the 11 (205,000) are under age 34
• 71 of uninsured adults (157,000) have jobs
• 70 of uninsured workers (105,000) work for small
  business
• There are also many uninsured who are dependents
  of people with jobs
• There are around 25,000 uninsured full-time
  college students
• The Young Immortals are the primary group of free
  riders in the health care system

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Who are Utahs Uninsured Children?
By poverty level
Source 2005 Health Status Survey
Note 100 FPL 20,000 a year for a family of
four
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Who are Utahs Uninsured Children?
By Hispanic ethnicity
Source 2005 Health Status Survey
Figures in these categories may not sum to the
total because of missing values on the grouping
variable.
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Who are Utahs Uninsured Children?
By urban or rural location
Source 2005 Health Status Survey
Figures in these categories may not sum to the
total because of missing values on the grouping
variable.
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Who are Utahs Uninsured Children?
By full-time worker in the household
Source 2005 Health Status Survey
Figures in these categories may not sum to the
total because of missing values on the grouping
variable.
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Who are Utahs Uninsured Children?
By length of time uninsured
Source 2005 Health Status Survey
Figures in these categories may not sum to the
total because of missing values on the grouping
variable.
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Progress to Date

• CHIP Expansion and Continuous Open Enrollment
  Almost 10,000 more children on CHIP than a year
  ago
• PCN Renewal Since July 2002, PCN has provided
  coverage for 48,680 Utahns that wouldnt have
  been able to afford it otherwise
• HB 156 Allows previously uninsurable
  individuals to purchase coverage that excludes
  non-life-threatening conditions at an affordable
  rate
• Premium Assistance 2006 Legislature approved
  funding for a demonstration premium assistance
  program for around 1,000 Utahns. Our HIFA waiver
  application was approved in October, 2006,
  creating the Utah Premium Partnership for Health
  Insurance (UPP).

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Moving Forward The Governors Proposal

• FIRST STEPS
• Insure Utahs Children
• Use Private Market Solutions The Utah Premium
  Partnership for Health Insurance (UPP)
• Help Small Business

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Insuring Utahs Children
Utahs Uninsured Children All children living
in the State of Utah should have health insurance.
ParentalResponsibility
Parental Responsibility Parents should be
responsible to pay for their childrens needed
health care. Should we require that parents
provide evidence of ability to pay, either
through insurance or some other way?
Uninsured Children
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How Utah Will Cover Its Uninsured Children
Parental Responsibility All parents can provide
health insurance for their children.
18,900
Household income greater than 200 of FPL
Must buy private insurance without financial help.
24,600
Household income between 100 and 200 of FPL
Meet income guidelines for CHIP. Qualify for the
UPP subsidy for private policies.
Total uninsured children71,300
FPL is the Federal Poverty Level, currently
20,000 per year for a family of four.
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Private Market Solutions
UPP Our current HIFA waiver created Utahs
Premium Partnership for Health Insurance (UPP)
that allows families to use state and federal
funds to purchase private health insurance for
qualifying children, adults, and possibly their
families.
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Helping Small Business

• An Insurance Exchange A clearinghouse that
  facilitates individual and small business
  purchase of health insurance.
• Tax free premium payments
• Employers control their costs
• Portable and flexible health plans for employees

The Insurance Exchange
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Overall Marginal Tax Rates (Example One parent
with two children, Wisconsin state information)
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Insuring Individuals and Employees of Small
Business
Utah Insurance Exchange

• The Utah Insurance Exchange is a clearinghouse
  for private health plans.
• Employers offer a pre-tax health plan to all
  employees
• Allows employers to use a defined contribution
  system
• Working families choose plans to meet their needs
  
• Health insurance premiums are tax free
• Health insurance becomes portable and flexible

Private Health Plans
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Putting it All TogetherUtahs Plan to Expand
Health Insurance Coverage for the Uninsured
Parental Responsibility
Insuring Utahs Uninsured Citizens
The Insurance Exchange
Uninsured Children