We are at a crucial time in the debate over healthcare access for the poor in the state of Utah.
Once again the Utah state legislature has finished a session without providing a resolution to the “coverage gap”, those who do not qualify for traditional Medicaid or for premium assistance under the Affordable Care Act.
As a lifelong member and returned missionary of The Church of Jesus Christ of Latter-Day Saints, I was overjoyed by the presence of Presiding Bishop Gary E. Stevenson at the press conference announcing Utah Governor Gary Herbert's Healthy Utah plan, and by the following statement issued by the Church:
"We recognize that providing adequate health care to individuals and families throughout Utah is a complex and weighty matter. It deserves the best thinking and efforts from both the public and the private sectors.
"While the economic and political realities are being debated, we hope the discussion and decisions taken in this matter will be consistent with the God-given principles regarding care for the poor and the needy that in the end benefit all of His children. We reaffirm the importance for individuals and families to be as self-sufficient as their particular circumstances allow and recognize that the lack of access to health care can impair a person's ability to provide for self and family.
"We commend public officials for their efforts to grapple with these difficult issues and pray for their success in finding solutions that reflect the highest aspirations of society."
Of course this doesn't constitute an official endorsement of Healthy Utah by the LDS Church, and it would be wholly inappropriate for me, as a member, to present it as such. It's a declaration of the LDS Church's beliefs and standards of caring for those in need, very much in line with the October 2014 General Conference talk by Elder Jeffery R. Holland of the Quorum of the Twelve, in which he charged members to do what they can to help. But, speaking only for myself, I believe that the only plan for closing the coverage gap currently under consideration by the Utah legislators that is consistent with these principles is Healthy Utah. The so-called Utah Cares plan, proposed by Rep. Jim Dunnigan, falls short to some degree on most of them. In my opinion, the "Do Nothing' option of rejecting all federal funding blatantly violates all of them. The alternative proposals fall short on at least some levels. Let me explain how by running down the principles discussed:
1. "EFFORTS FROM BOTH THE PUBLIC AND PRIVATE SECTOR"
Healthy Utah is a public program which benefits and utilizes the private sector by giving those in the coverage gap access to insurance from the private insurance market. In addition, Healthy Utah received roughly a year of review and consideration and review from the state and federal governments, and has been endorsed by over 70 prominent Utah organizations. “Utah Cares” had no such collaborative, bipartisan development, has not yet been reviewed by the federal government, and has received no endorsements from anyone but individual politicians.
2. "BENEFIT ALL HIS CHILDREN"
Healthy Utah benefits the poor by giving them access to insurance coverage, and respects the taxpayer by bringing back to Utah the maximum possible amount of our taxpayer dollars. Alternative proposals fall short of both of these goals, bringing coverage to fewer people and rejecting huge amounts of Utah taxpayer money. Under the Utah Cares plan, 40% of those in the coverage gap will only be covered by Utah’s Primary Care Network (PCN). PCN will help patients see primary care doctors, but does not pay for specialty care, emergency care, or substance use recovery, and is very limited in its coverage of prescription medication. Such a program can hardly be said to “benefit all His children.”
3. " AS SELF-SUFFICIENT AS THEIR PARTICULAR CIRCUMSTANCES ALLOW"
Research regarding Healthy Utah already shows us that stereotypes about those in the coverage gap are untrue. A study from the University of Utah shows that roughly two-thirds of those in the coverage gap currently work one or more jobs. These are the working poor, not people who don’t want to work. Healthy Utah also includes reasonable co-pays and premiums which encourage personal responsibility, but do not ask people to metaphorically "run faster than he has strength" (The Book of Mormon, Mosiah 4:27). Alternative proposal do not respect circumstances and ask exactly this. By reducing the coverage to only those at 100% of the coverage gap, these proposals force those at 101-138% to pay higher premiums and deductibles, with the only help coming from ACA subsidies that were never intended to be enough for people at this income level.
4. "THE LACK OF ACCESS TO HEALTHCARE CAN IMPAIR A PERSON'S ABILITY TO PROVIDE FOR SELF AND FAMILY"
This one is obvious: all proposals other than Healthy Utah leave a large number of people without reasonable, affordable access to healthcare. Healthy Utah even helps people to become more self-sufficient through the much discussed Work Effort which helps those who are unemployed or underemployed find employment or gain employable skills.
Again, I wish to stress that the conclusions drawn here are entirely my own. I'm not suggesting the LDS Church endorsed Healthy Utah, or that Mormons are obligated to support it. Merely that, fortunately, Healthy Utah fits all of the principles they did endorse. And unfortunately, the alternative plan proposed by Rep. Dunnigan does not.