Utah Health Care

                HOME                NEWS                GUEST BOOK               SITE MAP                ABOUT US


In 2014, the LAW requires everyone to have Health Insurance or pay a penalty.

Obamacare subsidies are for the needy and unemployed.                                                                  
For the rest of us, Insurance companies pay Obamacare 3.8%

OR compare numerous policies for your best rates, CLICK  


SALT LAKE CITY, Utah (ABC 4 Utah) – Utah Sen. Mike Lee is making a last-ditch effort to try to stop theAffordable Health Care Act in its tracks. 

But if his efforts, could shutdown the federal government.  In the three years after being signed into law, Republicans have tried to repeal ObamaCare more than three dozen times.  “This will probably be the last opportunity we'll have to not fund ObamaCare before these provisions are scheduled to take effect on January 1, 2014,” Sen. Lee told ABC 4 Utah’s Kim Johnson. “So in that respect, it's the end of the road.”

Lee is part of a group of senate Republicans proposing to block anygovernment funding resolution that includes money for ObamaCare. This fall, Congress is expected to vote on a continuing resolution that essentially keeps the federal government running when congress fails to pass a budget. 

“I and a group of senators have indicated that we will not vote for any continuing resolution that includes ObamaCare funding,” said Sen. Lee.  Lee said the intention is not to shutdown government, but to get Democrats to remove ObamaCare funding from the CR.  “We don’t want a shutdown, we don't need a shutdown, we're certainly not proposing a shutdown nor do we anticipate that Harry Reid would go so far as to shutdown the government just to defend a law that the president himself has acknowledged is not ready to be implemented,” he said.

If Lee is successful only parts of ObamaCare that haven't taken affect, such as the individual mandate, would be in jeopardy.
But even though the U.S. Supreme Court upheld the individual mandate and democrats say the law as a whole will lower insurance costs, Sen. Lee insists the law is bad for the country and is hoping other congressional republicans will join him in perhaps a final effort to stop it.

“We have some leverage here, let's use that and let's get this done,” he said.  Lee said support for his plan is growing. Right now 15 senators have signed on, but more than 40 will be needed to block the continuing resolution.

Utah Makes Unique Obamacare Exchange Deal

Monday, 13 May 2013 02:44 PM

By Courtney Coren

   . .

Utah will be the sole state to run its own Small Business Health Options Program exchange under Obamacare, while leaving the federal government to set up the exchange for the individual market, Politico reports

Gov. Gary Herbert said the White House has approved the state's proposal to run only the small-business part of the healthcare exchange. It is the only state that has proposed splitting the exchange into two parts. 

The Beehive State will manage the small-business exchange according to its own rules, while the federal government will run the individual exchange according to similar rules used in other states.

"The only way this was going to work was if we were granted flexibility," the Republican governor said. "Fortunately for all, [the Department of Health and Human Services] proved to be flexible, concurring with everything we proposed to be able to operate an exchange that meets the needs of Utah residents."

One of the main concerns Herbert had was the amount of data that Utah would be required to share with the federal government. He was worried that he would violate state law by sharing information regarding individuals or employers using the small business exchange.

"HHS acknowledges our limitations and agreed to my proposal," he said.


Group Health Insurance in Utah
  • For those who are eligible, group health insurance may not be denied, and providers may not charge more because of health issues.
  • Life changes related to family or unemployment may create special opportunities for group coverage.
  • Employer may require a waiting period before offering coverage to new employees.
  • A new HMO may require an affiliation period.
  • In the case of a pre-existing condition, providers may require an exclusion period of up to 12 months.
  • Providers may review an applicant’s medical history for the six months prior to receiving coverage to look for pre-existing conditions.
  • If continuous coverage is maintained without a break longer than 63 days, creditable coverage may be applied to exclusion periods.

Small Business Health Insurance in Utah

  • Small businesses with up to 50 employees may not be denied small group health insurance or be cancelled because of sickness within the employee group.
  • Insurance providers must offer standardized plans.
  • For small group insurance, there are limits on the cost of premiums.
  • Small businesses with up to 50 employees may join a statewide and approved purchasing alliance for group health insurance coverage.
  • For regulations on associations which offer group coverage, contact the Utah Insurance Department.

Utah Insurance Department
3110 State Office Building
Salt Lake City, UT 84114

Self-Employed Health Insurance in Utah

The self-employed may not purchase group insurance.

Individual Health Insurance in Utah

  • Those who are eligible for coverage through an employer, an association, COBRA, Utah’s continuation coverage, conversion coverage, Medicaid, Medicare, or HIPUtah program must be offered coverage by providers.
  • Providers may deny coverage to everyone else based on health problems.
  • Utah requires all individual insurance providers to offer standardized policies which contain specific benefits.
  • In the case of a pre-existing condition, individual providers may attach an elimination rider or an exclusion period for up to 12 months.
  • Creditable coverage is allowed.
  • Pregnancy may be considered a pre-existing condition.
  • For HIPAA eligible individuals who cannot buy HIPUtah, no exclusion period may be imposed.
  • Premiums are based on the average of small group health insurance.
  • Limits may be placed due to health problems.
  • For renewal, there are no limits based on age and health.
  • Individual coverage may not be cancelled due to sickness.
  • Regence Blue Cross Blue Shield administers Utah’s Comprehensive Health Insurance Pool to anyone unable to purchase individual health insurance.

Utah Health Care Programs

Medicaid, Children’s Health Insurance Program, and Utah Cancer Control Program offer assistance to low income individuals and families.

Location Status of State Exchange Decision Medicaid Expansion Decision Executive Activity
Utah Default to Federal Exchange8 Opposes5