COBI 2013 - Comprehensive Health Insurance Pool

Compendium of Budget Information for the 2013 General Session

Business, Economic Development, & Labor
Appropriations Subcommittee

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Agency: Insurance

Line Item: Comprehensive Health Insurance Pool

Function

The Utah Comprehensive Health Insurance Pool, (HIPUtah), is a state-subsidized health insurance program that serves as a safety net for citizens of Utah with serious medical conditions that make them uninsurable. HIPUtah has provided health insurance for the medically uninsurable since 1991 and currently provides coverage for more than 3,600 individuals. HIPUtah is funded as a separate line item under the Insurance Department.

HIPUtah plays three roles in the State:

HipUtah makes it possible for individual Utahans with an uninsurable medical condition to purchase insurance.
HipUtah satisfies federal requirements of the Health Insurance Portability and Accountability Act of 1996 (i.e., HIPAA Portability).
HIPUtah is an important link in the overall wellbeing of the individual and small group insurance markets.

Health Insurance Program Utah (HIPUtah) is funded as its own line item, separate from the other Insurance Department line items.

As of July 2010 in response to the federal Patient Protection and Affordable Care Act (PPACA), the state entered into a contract with U.S. Health and Human Services to operate the "Pre-Existing Condition Insurance Plan" (PCIP) known as Federal HIPUtah. Federal HIP is a temporary high-risk health insurance pool to provide health insurance coverage to currently uninsured individuals with pre-existing conditions who have been without insurance for at least 6 months. This federal program is run in conjunction with the state program and provides coverage for approximately 1,200 individuals.

Federal HIPUtah will only provide coverage until 2014, when health exchanges become available and pre-existing condition exclusions are prohibited. To date, Federal HIPUtah has been allocated approximately $460 million to provide coverage for about 2,400 individuals through 2014. No state funds are used to operate the federal high risk pool.

Funding Detail

As mentioned above, funding for the federal high risk pool is comprised largely of federal dollars and includes dedicated credits from the premiums paid by members of the program. Funding for the state high rish pool is made up of a general fund subsidy as approved by the Legislature, dedicated credits from premiums paid by members of the pool, and a small portion of federal grant funds.

Sources of Finance (click linked fund name for more info)	2009 Actual	2010 Actual	2011 Actual	2012 Actual	2013 Approp
General Fund	$8,500,000	$8,500,000	$8,075,000	$8,075,000	$8,083,500
General Fund, One-time	$800,000	$0	$0	$0	$0
Federal Funds	$1,440,800	$2,040,600	$5,462,500	$851,400	$1,900,000
Dedicated Credits Revenue	$20,013,000	$20,977,800	$23,932,600	$22,840,500	$25,554,200
Beginning Nonlapsing	$31,042,600	$31,521,000	$27,985,700	$22,776,600	$14,343,800
Closing Nonlapsing	($31,521,000)	($27,985,700)	($22,828,900)	($20,372,700)	($8,420,800)
Total	$30,275,400	$35,053,700	$42,626,900	$34,170,800	$41,460,700

Programs: (click linked program name to drill-down)	2009 Actual	2010 Actual	2011 Actual	2012 Actual	2013 Approp
Comprehensive Health Insurance Pool	$30,275,400	$35,053,700	$42,626,900	$34,170,800	$41,460,700
Total	$30,275,400	$35,053,700	$42,626,900	$34,170,800	$41,460,700

Categories of Expenditure (mouse-over category name for definition)	2009 Actual	2010 Actual	2011 Actual	2012 Actual	2013 Approp
In-state Travel	$3,700	$0	$0	$0	$0
Out-of-state Travel	$0	$2,000	$4,200	$2,800	$5,000
Current Expense	$30,262,900	$34,644,700	$42,269,900	$34,725,100	$41,455,700
Other Charges/Pass Thru	$8,800	$407,000	$352,800	($557,100)	$0
Total	$30,275,400	$35,053,700	$42,626,900	$34,170,800	$41,460,700

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COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.