Federal & State Regulations | State insurance exchange - Utah

Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that states may submit both a letter of intent and an application to operate its own exchange by December 14. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

Former Utah Governor Huntsman signed legislation in 2008 (HB 133) and 2009 (HB 188), which directed the Office of Consumer Health Services to create the Utah Health Exchange. In 2010 and 2011, current Governor Herbert signed into law additional legislation (HB 294 and HB 128) amending provisions related to health system reform, and in 2012 further legislation was introduced (HB 144). The Utah Health Exchange allows small employers to participate in a defined contribution arrangement and compare, select, and enroll in commercial health insurance online.

In 2011, Governor Herbert also signed HB 354 into law, which bans abortion coverage in any private plan sold in Utah, including the Exchange, except in cases of rape, incest, fetal abnormality, or life endangerment or severe impairment of the pregnant woman.

Utah was awarded a $1 million Exchange Planning grant in 2010.

Utah is currently planning for changes to its Exchange in order to comply with federal health reform regulations. December 14, 2012, is the deadline for Utah to submit an exchange blueprint consisting of a declaration letter signed by Governor Herbert and an application to the U.S. Department of Health and Human Services, if it intends to operate a state-based exchange or a state-federal partnership exchange.