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Lawmakers Decide on Benchmark Health Insurance Plan

The state’s Health System Reform Task Force has decided on essential health benefits that all insurance companies must cover.  Lawmakers argued that the benchmark plan should cover the bare minimum to keep it affordable, but some advocates are concerned that it falls short in some areas.

Lawmakers were tasked with choosing among ten of Utah’s existing insurance plans to meet the requirement of the Affordable Care Act.  The plan they chose is based on the state’s Public Employees Health Program called Utah Basic Plus.  Kelly Atkinson is Executive Director of the Utah Health Insurance Association.

“This Essential Benefit Program has the potential of bringing the young immortals - people who are healthy and think they are never going to get sick - into the insurance market to become insured,” Atkinson told the task force, “That’s a good thing for the citizens of the state of Utah and the taxpayers of the state of Utah.”

Some health advocacy groups found the plan lacking in services covered for those with autism, disabilities, and mental health issues.  Adam Troop is with the Association of Counties in Utah.

“Our concern is as we look at an essential health benefit and the basic requirement that we actually are looking at something that meets the needs for treatment of those folks who have substance abuse disorder treatment needs and mental health treatment needs,” said Troop.

Lawmakers insisted that insurers were not limited to the benchmark plan.  They voted unanimously to adopt PEHP’s Utah Basic Plus as the standard.  The task force’s recommendation now goes to Utah’s Insurance Commissioner who then has 30 days to act on it. 

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