Healthy Utah plan.

• Author: Dicou, Natalie Kaye
• Position: TIMEOUT FOR HEALTH - Health insurance coverage

Whether on the radio or at your favorite coffee shop, you've likely heard the buzz surrounding Healthy Utah, Gov. Herbert's recently unveiled plan to extend health insurance coverage to our state's poorest citizens.

"Over the last 18 months, Gov. Herbert has taken time to listen carefully to constituents and leaders and to reflect deeply on the needs of our population," said Vivian Lee, M.D., Ph.D., M.B.A., senior vice president of University of Utah Health Sciences. "The Healthy Utah proposal he and his team put forward is an approach unique to Utah that will advance the health of our state."

So, what is Healthy Utah? Who are the beneficiaries? How is the plan related to the Affordable Care Act (ACA)? And finally, what does it mean for the health and pocketbooks of Utahns? These questions are enough to make even seasoned health care experts' heads spin. Let's break it down.

Ever since the ACA, or "Obamacare," went into effect, Utahns --just like all U.S. taxpayers--have funded the ACA through their tax dollars. Funds were intended to go toward expanding Medicaid, but a U.S. Supreme Court ruling allowed states to opt out--and Utah and many other states did just that, preferring to find a local solution. In 2014, Utah turned away more than $450 million, or $1.2 million a day--money that's being used to fund the Medicaid expansions in other states.

Gov. Herbert has negotiated a plan with the federal government to take back our tax dollars and provide insurance to low-income Utahns. Instead of expanding Medicaid in the traditional sense, the funds will be used to buy private health plans, either through Utah's online exchange--Avenue H--or through coverage offered by a recipient's employer.

During Healthy Utah's first year, approximately 89,000 Utahns will receive coverage. These individuals are adults between the ages of 19-64 who earn annual incomes of less than $15,521. In comparison, the median household income in Utah is $57,783.

Gov. Herbert's plan is exclusively designed to bolster and preserve Utah's values. It promotes individual responsibility by enrolling adults who can work in an integrated work program and obligating them to participate in cost sharing. Members will be charged some form of copay, and individuals above the federal poverty level will have higher copays and pay a premium.

The plan supports the private market by providing individuals with assistance to buy insurance plans from private companies. Another boon for...