February 9, 2015

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Taking a Pulse

A Look at the Affordable Care Act’s Impact across Utah

By Emma Penrod

February 9, 2015

After listening to endless complaints from residents and businesses alike, experts didn’t really expect large numbers of Utahns to sign up for the Affordable Care Act. But when the marketplace opened for the first time last year, Utah residents signed up for insurance in droves, with some demographics signing up faster than their counterparts in many other states. And with tens of thousands of Utahns still without insurance, those same experts who once predicted a low adoption rate in Utah now anticipate a big year for insurance enrollment in 2015—even though they say the act still has a lot of challenges to overcome.

By the Numbers

Nearly 85,0000 Utahns signed up for insurance through the Affordable Care Act’s online insurance marketplace in its first year—30,000 more than state experts initially anticipated, says Jason Stevenson, education and communication director for the Utah Health Policy Project, a nonprofit, nonpartisan group dedicated to sustainable healthcare.

“We weren’t sure there would be a demand for this in Utah,” Stevenson says, because so many Utahns get health insurance coverage through their employers—almost 60 percent of Utah residents have employer-provided health insurance, compared to a national average of just under 50 percent. “But demand was huge,” says Stevenson. Indeed, 84,601 Utahns had signed up for health insurance through healthcare.gov by April 19, 2014. Nearly 45,000 of them signed up in the last month before the extended ACA deadline.

Who signed up for healthcare was perhaps just as surprising as how many signed up. It wasn’t the elderly or individuals with pre-existing conditions who clamored for coverage—though there were those, too, says Randal Serr, director of Take Care Utah, a partnership between UHPP, the Association for Utah Community Health (AUCH) and the United Way of Salt Lake/2-1-1 that answers health insurance questions and offers enrollment assistance to Utahns.

Serr says he was aware of at least one enrollee, in her 30s, who had been previously denied health coverage because of a pre-existing brain tumor. Her condition had rendered her unable to work, and her lack of insurance and income made it impossible for her to seek medical treatment. But after enrolling under the Affordable Care Act, the woman was able to have the tumor successfully removed, and she was able to return to work once again, Serr says.

But for the most part, younger Utahns made up the bulk of the new enrollees through the marketplace, and many of those young enrollees were self-employed or otherwise engaged in some form of nontraditional employment. In fact, Stevenson says, the data suggested the No. 1 fastest enrolling community in Utah was Daybreak, a South Jordan neighborhood typified by young, hardworking families.

Utahns under the age of 26 were also more likely than their counterparts in other states to take advantage of new Affordable Care Act provisions to stay insured under their parents’ policies, possibly because so many young Utahns choose to serve missions for The Church of Jesus Christ of Latter-day Saints and attend college later in life. Between this and the rush on marketplace enrollment, the number of young uninsured Utahns plummeted. “We had more young enrollments than any other state,” Stevenson says. “I think what they found out was that rates were pretty low, so they signed up.”

Though preliminary data from PricewaterhouseCoopers indicates premiums are up by an average of 5.3 percent for 2015, insurance rates in Utah remain among the lowest in the nation. Kaiser Health News put Utah in the top 10 markets for affordable insurance rates, based on an average cost of $173 a month for a 40-year-old interested in a low-cost, silver-grade health policy. For Utahns in their 20s and 30s, rates could run lower, with the cheapest silver-grade health policies coming in around $115 per month.

The availability of subsidies through the Affordable Care Act further reduced the out-of-pocket cost of health insurance for young Utahns, Stevenson says—and 65 percent of Utahns who sought insurance through the marketplace last year received a monthly subsidy worth $50 or more. American families with a household income within 400 percent of the federal poverty level qualify for subsidies. That means subsidies are available for an average family of four making anything less than $95,400.

More Insurance—and Questions

After 2014’s high enrollment, experts expect the 2015 insurance exchange at healthcare.gov to bring in even more uninsured Utahns—and while that’s probably a good thing for consumers, the jury is still out on how that will impact insurance companies, says Shaun Greene, founder and COO of Arches, a nonprofit insurance provider.

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