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Health Insurance for Utah Children and Small Businesses
November 15, 2006
Expanding Health Insurance Coverage for Utah’s Uninsured Citizens
What is our focus and why?
Nearly 300,000 Utahns are uninsured
This is a problem-A. Most of the cost of uncompensated care is being passed on to Utah’s businesses that provide health benefits to their employees
-B. Uninsured people get less effective and more expensive health care
Over 70,000 of the uninsured are children (0-18)
Over 100,000 of the uninsured work for small businesses
Our two primary goals:-Make sure Utah children have health insurance-Make it easier for employees of Utah small businesses to get health insurance
Who are the 11.6%?
Currently Uninsured (11.6%) 292,800By Age:-Children, Under 19 years old (24%) 71,300-Young Adults, 19 to 34 years old (45%) 132,000-Adults, 35 years old or older (31%) 91,500-Note: Figures in these categories do not sum to the total because of missing values on the grouping variable.
By Employment Status:-Adults, 19-64 with Full-time jobs (38%) 110,300-Adults, 19-64 with Part-time jobs (14%) 43,000-Adults, 19-64 who are Self-employed (16%) 46,700
Utah’s “Most Likely” Uninsured Person:-White male-Between the ages of 19 and 34-High school graduate, with no college degree-Full time job-Household income between $20,000 and $45,000
Key Factors – The Young Immortals
70% of the 11% (205,000) are under age 34
71% of uninsured adults (157,000) have jobs
70% of uninsured workers (105,000) work for small business
There are also many uninsured who are dependents of people with jobs
There are around 25,000 uninsured full-time college students
The Young Immortals are the primary group of free riders in the health care system
Who are Utah’s Uninsured Children?
27,800
24,600
18,900
<100% FPL
101-200% FPL
>200% FPL
By poverty level
Source: 2005 Health Status Survey
Note: 100% FPL = $20,000 a year for a family of four
Who are Utah’s Uninsured Children?
31,000
40,100
Hispanic
Not Hispanic
By Hispanic ethnicity
Source: 2005 Health Status SurveyFigures in these categories may not sum to the total because of missing values on the grouping variable.
Who are Utah’s Uninsured Children?
56,700
14,600
Wasatch Front
Other
By urban or rural location
Source: 2005 Health Status SurveyFigures in these categories may not sum to the total because of missing values on the grouping variable.
Who are Utah’s Uninsured Children?
59,000
12,300
Full-timeWorker in theHouseholdNo Full-timeWorker Present
By full-time worker in the household
Source: 2005 Health Status SurveyFigures in these categories may not sum to the total because of missing values on the grouping variable.
Who are Utah’s Uninsured Children?
17,900
53,300
Less than 1year
1 Year or longer
By length of time uninsured
Source: 2005 Health Status SurveyFigures in these categories may not sum to the total because of missing values on the grouping variable.
Progress to Date
CHIP Expansion and Continuous Open Enrollment – Almost 10,000 more children on CHIP than a year ago
PCN Renewal – Since July 2002, PCN has provided coverage for 48,680 Utahns that wouldn’t have been able to afford it otherwise
HB 156 – Allows previously uninsurable individuals to purchase coverage that excludes non-life-threatening conditions at an affordable rate
Premium Assistance – 2006 Legislature approved funding for a demonstration premium assistance program for around 1,000 Utahns. Our HIFA waiver application was approved in October, 2006, creating the Utah Premium Partnership for Health Insurance (UPP).
Moving Forward – The Governor’s Proposal
FIRST STEPS:
Insure Utah’s Children
Use Private Market Solutions – The Utah Premium Partnership for Health Insurance (UPP)
Help Small Business
UninsuredChildren
ParentalResponsibility
Insuring Utah’s Children
Utah’s Uninsured Children – All children living in the State of Utah should have health insurance.
Parental Responsibility – Parents should be responsible to pay for their children’s needed health care. Should we require that parents provide evidence of ability to pay, either through insurance or some other way?
Total uninsured
children71,300
27,800
Household income less than 100% of FPL*
They are eligible for Medicaid but haven’t signed up yet.
They should be enrolled in Medicaid.
*”FPL” is the Federal Poverty Level, currently $20,000 per year for a family of four.
18,900
24,600
Household income between 100% and 200% of FPL*
Household income greater than 200% of FPL*
Meet income guidelines for CHIP. Qualify for the UPP subsidy for private policies.
Must buy private insurance without financial help.
Parental Responsibility – All parents can provide health insurance for their children.
How Utah Will Cover Its Uninsured Children
Private Market Solutions
UPP – Our current HIFA waiver created Utah’s Premium Partnership for Health Insurance (UPP) that allows families to use state and federal funds to purchase private health insurance for qualifying children, adults, and possibly their families.
The InsuranceExchange
Helping Small Business
An Insurance “Exchange” – A clearinghouse that facilitates individual and small business purchase of health insurance.
•Tax free premium payments
•Employers control their costs
•Portable and flexible health plans for employees
Overall Marginal Tax Rates (Example: One parent with two children, Wisconsin state information)
0%
10%
20%
30%
40%
50%
60%
$9,398 $11,862 $13,687 $17,337 $20,986 $24,636 $29,198 $34,673 $40,148 $45,623 $51,097
Family Income
Ta
x S
ub
sid
y P
erc
en
tag
e
State
FICA
Federal
Utah Insurance Exchange
PrivateHealth Plans
Defined contribution(pre-tax)
Employers
Subsidy for qualifying families
UPP
The Utah Insurance Exchange is a clearinghouse for private health plans.
• Employers offer a pre-tax health plan to all employees
• Allows employers to use a defined contribution system
• Working families choose plans to meet their needs
• Health insurance premiums are tax free• Health insurance becomes portable and
flexible
WorkingFamilies
Pre-tax Premiums
Choice of Private Health Plan
Insuring Individuals and Employees of Small Business