State Codes and Statutes
Statutes > Utah > Title-63m > Chapter-01 > 63m-1-250563M-1-2505. Strategic plan for health system reform.
The state's strategic plan for health system reform shall include consideration of thefollowing:
(1) legislation necessary to allow a health insurer in the state to offer one or more healthbenefit plans that:
(a) allow an individual to purchase a policy for individual or family coverage, with orwithout employer contributions, and keep the policy even if the individual changes employment;
(b) incorporate rating practices and issue practices that will sustain a viable insurancemarket and provide affordable health insurance products for the most purchasers;
(c) are based on minimum required coverages that result in a lower premium than mostcurrent health insurance products;
(d) include coverage for immunizations, screenings, and other preventive health services;
(e) encourage cost-effective use of health care systems;
(f) minimize risk-skimming insurance benefit designs;
(g) maximize the use of federal and state income tax policies to allow for payment ofhealth insurance products with tax-exempt funds;
(h) may include other innovative provisions that may lower the costs of health insuranceproducts;
(i) may incorporate innovative consumer-driven provisions, including:
(i) an exemption from selected state health insurance laws and regulations;
(ii) a range of benefit and cost sharing provisions tailored to the health status, financialcapacity, and preferences of individual consumers; and
(iii) varying the amount of cost sharing for a service based on where the service fallsalong a continuum of care ranging from preventive care to purely elective care; and
(j) encourage employers to allow their employees greater control of the employee's healthcare benefits by providing tax-exempt defined contributions for the purchase of health insuranceby either the employer or the employee;
(2) current rating and issue practices by health insurers and changes that may benecessary to achieve the goals of Subsection (1)(b);
(3) methods to decrease cost shifting from the uninsured and under-insured to theinsured, health care providers and taxpayers, including:
(a) eligibility and benefit levels for entitlement programs;
(b) reimbursement rates for entitlement programs; and
(c) the Utah Premium Partnership for Health Insurance Program and the Children'sHealth Insurance Program's enrollment and benefit policies, and whether those policies provideappropriate and effective coverage for children;
(4) providing public employees an option that gives them greater control of their healthcare benefits through a system of defined contributions for insurance policies;
(5) giving public employees access to an option that provides individually selected andowned policies;
(6) encouraging the use of health care quality measures and the adoption of best practiceprotocols by health care providers for the benefit of consumers, health care providers, and thirdparty payers;
(7) providing some protection from liability for health care providers who follow bestpractice protocols;
(8) promoting personal responsibility through:
(a) obtaining health insurance;
(b) achieving self reliance;
(c) making healthy choices; and
(d) encouraging healthy behaviors and lifestyles to the full extent allowed by the HealthInsurance Portability and Accountability Act;
(9) studying the costs and benefits associated with:
(a) different forms of mandates for individual responsibility; and
(b) potential enforcement mechanisms for individual responsibility;
(10) (a) increasing the number of affordable health insurance policies available to aperson responsible for obtaining health insurance under Subsection (8)(a) by creating a system ofsubsidies and Medicaid waivers that bring more people into the private insurance market; and
(b) funding subsidies to support bringing more people into the private insurance market,which may include:
(i) imposing assessments on:
(A) health care facilities;
(B) health care providers;
(C) health care services; and
(D) health insurance products; or
(ii) relying on other funding sources;
(11) investigating and applying for Medicaid waivers that will promote the use of privatesector health insurance;
(12) identifying federal barriers to state health system reform and seeking collaborativesolutions to those barriers;
(13) maximizing the use of pre-tax dollars for health insurance premium payments;
(14) requiring employers in the state to adopt mechanisms that allow an employee to usetax-exempt earnings, other than pre-tax contributions by the employer, to purchase a healthinsurance product;
(15) extending a preference under the state procurement code for bidders who offergoods or services to the state if the bidder provides health insurance benefits or a definedcontribution for health insurance to the bidder's employees; and
(16) requiring insurers to accept premium payments from multiple sources, includingstate-funded subsidies.
Enacted by Chapter 383, 2008 General Session
