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H.C.R. 10 Enrolled

             1     

CONCURRENT RESOLUTION ON THE PATIENT

             2     
PROTECTION AND AFFORDABLE CARE ACT AND STATE

             3     
HEALTH CARE REFORM

             4     
2013 GENERAL SESSION

             5     
STATE OF UTAH

             6     
Chief Sponsor: Ken Ivory

             7     
Senate Sponsor: J. Stuart Adams

             8     
             9      LONG TITLE
             10      General Description:
             11          This concurrent resolution describes the impacts of the federal Patient Protection and
             12      Affordable Care Act on Utah families, employers, insurers, health care providers, and
             13      the state, and urges actions to ensure the continued success of state-based health care
             14      innovation and reform.
             15      Highlighted Provisions:
             16          This resolution:
             17          .    describes the impacts of the federal Patient Protection and Affordable Care Act
             18      (ACA) on Utah families, employers, insurers, health care providers, and the state;
             19          .    urges the state's Congressional delegation to continue its efforts to arrest the
             20      devastating impacts of the ACA using all means possible, including repeal of the
             21      act;
             22          .    urges Utah's Congressional delegation to work cooperatively with others to develop
             23      workable alternatives to the ACA;
             24          .    affirms the state's policy that no person in this state should be required to either
             25      sponsor or enroll in health insurance;
             26          .    urges the Legislature's Health Reform Task Force to continue working cooperatively
             27      with the Governor's Office to ensure that ACA implementation rules address the
             28      needs of Utah health care stakeholders;
             29          .    urges all stakeholders in Utah's health care system to continue working


             30      cooperatively to develop state-based health care reforms; and
             31          .    specifies to whom this resolution should be sent.
             32      Special Clauses:
             33          None
             34     
             35      Be it resolved by the Legislature of the state of Utah, the Governor concurring therein:
             36          WHEREAS, the federal Patient Protection and Affordable Care Act and its companion
             37      legislation, the Health Care and Education Reconciliation Act of 2010, referred to jointly as
             38      "the Affordable Care Act," "the ACA," or "Obamacare," were enacted in March 2010;
             39          WHEREAS, under the ACA, Utah families, employers, manufacturers, and insurers
             40      will pay at least 18 new or increased taxes and fees that over 10 years will transfer $500 billion
             41      from the private sector to the public sector, suppressing economic growth and reducing
             42      employment in the state;
             43          WHEREAS, hundreds of Utah medical device companies will be subject to the ACA's
             44      excise tax on manufacturers and importers of certain medical devices, without regard for
             45      company profitability;
             46          WHEREAS, the tax will threaten the viability of many firms and have a chilling effect
             47      on the very innovation needed to drive down health care costs and support economic growth in
             48      this state;
             49          WHEREAS, Utahns will suffer further reductions in employment growth and economic
             50      activity as employers comply with uncompensated regulatory burdens imposed by the ACA;
             51          WHEREAS, Utah families will also pay more for goods and services as employers,
             52      insurers, and medical providers pass along various costs imposed by the ACA;
             53          WHEREAS, health insurance premiums for certain younger, healthier Utahns will more
             54      than double in 2014 as the result of various ACA provisions, including a prohibition on
             55      medical underwriting and restrictions on the use of age-based premiums;
             56          WHEREAS, the cost of insurance for many other Utah families will go up as well in
             57      response to ACA provisions that are known to drive up costs, including prohibitions on


             58      pre-existing condition exclusions, annual benefit limits, and lifetime benefit limits;
             59          WHEREAS, the ACA will penalize Utah employers that have more than 50 employees
             60      if they do not offer health insurance to their employees, even if an employer cannot afford
             61      insurance or chooses instead to compensate employees with higher wages, larger retirement
             62      contributions, or other employee benefits;
             63          WHEREAS, working Utah families will have fewer full-time employment
             64      opportunities as employers replace full-time workers with part-time workers to avoid ACA
             65      penalties;
             66          WHEREAS, some Utah families will be unable to keep their current health insurance
             67      and may have fewer options as employers abandon plans not meeting minimum benefit and
             68      affordability requirements in order to avoid ACA penalties;
             69          WHEREAS, working Utah families will find it even harder to secure employment with
             70      health insurance benefits as premium increases continue unabated in response to both the ACA
             71      and long-term cost drivers not addressed by the ACA;
             72          WHEREAS, many Utahns will face increased premiums as their insurers attempt to
             73      fund $81 million in losses created by the ACA's transfer of individuals from publicly funded
             74      high-risk pools to the private insurance market;
             75          WHEREAS, many Utah families with insurance offered by small or midsize employers
             76      could be threatened with higher premiums or no insurance at all if commercial insurance risk
             77      increases too much as the result of employers dropping coverage or switching to self-insurance
             78      arrangements;
             79          WHEREAS, there is a high likelihood that many Utah families will experience higher
             80      premiums due to the ACA's minimum benefit requirements, which threaten to ratchet up plan
             81      costs both inside and outside health insurance exchanges;
             82          WHEREAS, Utah families will pay higher insurance premiums because of ACA
             83      provisions that subsidize states with high-cost, poorly managed health care plans at the expense
             84      of states like Utah that have low-cost, better managed plans;
             85          WHEREAS, Utah seniors will likely have fewer care options due to Medicare provider


             86      payment reductions made by the ACA;
             87          WHEREAS, Medicaid enrollees will likely have greater difficulty making appointments
             88      with health care providers as Medicaid enrollment expands under the ACA, particularly after
             89      the two-year enhanced reimbursement rate for primary care providers ends;
             90          WHEREAS, Utah hospitals will suffer as a result of ACA reductions in funds paid to
             91      hospitals that serve a disproportionate number of low-income individuals;
             92          WHEREAS, Utah families will suffer if medical facilities close or medical practitioners
             93      leave their professions in response to the financial strain created by shrinking provider
             94      payments under the ACA;
             95          WHEREAS, state funding for education, roads, public safety, and other important
             96      services will be crowded by a $46 million annual liability to pay for the ACA's mandatory
             97      Medicaid eligibility expansion;
             98          WHEREAS, we and our children must one day pay the price for entitlements Congress
             99      has created but failed to realistically fund, including the ACA;
             100          WHEREAS, that price already includes tax increases and cost shifting to our posterity,
             101      and will likely include benefit reductions and even currency devaluation;
             102          WHEREAS, that price will tend to include the shifting of greater fiscal responsibility
             103      for government programs--including Medicaid--from Washington to the states, even further
             104      crowding out funding for education and other essential state services;
             105          WHEREAS, the real cost of more Utahns having insurance under the ACA will be a far
             106      greater dependence on government, not less;
             107          WHEREAS, under an optional Medicaid expansion the state would incur large,
             108      ongoing funding liabilities and both the state and its citizens would be more dependent, not less
             109      dependent, on a fiscally unsustainable federal government;
             110          WHEREAS, Utah has refused to exacerbate the federal fiscal crisis by choosing not to
             111      implement the ACA's federally subsidized health insurance exchange, which makes people
             112      dependent on large government subsidies and gives priority to publicly funded, rather than
             113      privately funded, coverage;


             114          WHEREAS, because of the ACA, Utah employers, insurers, and health care providers
             115      will face more regulation, not less regulation, and will have fewer options, not more options,
             116      for addressing the underlying challenges faced by our health care system;
             117          WHEREAS, notwithstanding the ACA's focus on preventive care and its
             118      acknowledgment of alternative payment and delivery systems, many Utahns will see little relief
             119      from premium increases driven by underlying problems the ACA fails to address, including
             120      reliance on payment and delivery systems that promote over consumption of health care;
             121          WHEREAS, implementation of the ACA will tend to destroy the private market for
             122      health insurance and move families, insurers, and health care providers ever closer to a
             123      single-payer system of federally controlled health care;
             124          WHEREAS, the state, its citizens, employers, insurers, and health care providers will
             125      all suffer as the ACA fails to bring unsustainable health care spending under control and
             126      metastasises instead into greater federal regulation and control of not just health care, but most
             127      aspects of Utahns' and Americans' daily lives and activities;
             128          WHEREAS, the ACA disregards state jurisdiction over health care policy and
             129      constrains the state's efforts to develop and implement meaningful health care reform; and
             130          WHEREAS, the Legislature and the Governor believe that successful reform of health
             131      care's most vexing problems will require more--not less--state flexibility and innovation:
             132          NOW, THEREFORE, BE IT RESOLVED that the Legislature of the state of Utah, the
             133      Governor concurring therein, urges the state's Congressional delegation to continue its efforts
             134      to arrest the devastating impacts of the ACA on Utah's economy, its citizens, its employers, its
             135      medical providers, and its insurers, using all means possible, including repeal of the act;
             136          BE IT FURTHER RESOLVED that the Legislature and the Governor urge Utah's
             137      Congressional delegation to work cooperatively with other members of Congress and officials
             138      of this state and other states to develop workable alternatives to the ACA that encourage state
             139      innovation, preserve states' policy-making jurisdiction and regulatory authority, and lead to
             140      greater enrollment in affordable health insurance;
             141          BE IT FURTHER RESOLVED that the Legislature and the Governor affirm by this


             142      resolution the state's policy that no person in this state should be required to either sponsor or
             143      enroll in health insurance, particularly under threat of federal penalty;
             144          BE IT FURTHER RESOLVED that the Legislature and the Governor urge the
             145      Legislature's Health Reform Task Force to continue working cooperatively with the Governor's
             146      Office to ensure that ACA implementation rules address the needs of Utah families, employers,
             147      health care providers, insurers, and insurance regulators;
             148          BE IT FURTHER RESOLVED that the Legislature and the Governor urge all
             149      stakeholders in Utah's health care system--including families, employers, health care providers,
             150      and insurers--to continue working cooperatively with the Governor and the Legislature to
             151      develop state-based health care reforms with the greatest potential for increasing consumerism,
             152      improving quality of care, constraining spending growth, and promoting enrollment in
             153      affordable health insurance, regardless of how ACA implementation unfolds;
             154          BE IT FURTHER RESOLVED that this resolution be sent to the United States
             155      Secretary of Health and Human Services, the Governor, the Legislature's Health Reform Task
             156      Force, Utah's Congressional delegation, the Utah Health Policy Project and other consumer
             157      advocacy groups, the Salt Lake Chamber of Commerce and other employer associations, the
             158      Utah Hospital Association, the Utah Medical Association, Utah insurers, the Utah Association
             159      of Health Underwriters, and the Speakers and Presidents presiding over the legislatures of each
             160      of the 49 other states.


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