Uncertain future for health plan covering thousands of Utahns

Uncertain future for health plan covering thousands of Utahns

OGDEN, Utah (ABC 4 Utah) – Thousands of Utahns are concerned about what will happen to their health care coverage as the Affordable Care Act kicks in and the state debates what to do about Medicaid expansion.
OGDEN, Utah (ABC 4 Utah) – Thousands of Utahns are concerned about what will happen to their health care coverage as the Affordable Care Act kicks in and the state debates what to do about Medicaid expansion.

Ogden resident, Jared Legge is one of them, he is dealing with a nagging injury.

"About 13 years ago I had two back surgeries done on my back. I've been trying to recover from those and I discovered that my back is going bad again,” said Legge.

He doesn't qualify for health insurance through work and he doesn't meet the requirements for Medicaid.

That's where Primary Care Network or PCN comes in.

It’s a state run program, funded mostly by federal money, offering basic care options.

"Basic doctor visits, four prescriptions a month," said Legge.

Recently he's been informed the future of PCN is up in the air.

"I got a notice at the end of the certification process that the PCN program could close at any time without warning," said Legge.

That’s because the 16,000 Utahns covered by PCN would have been included in full Medicaid expansion under the Affordable Care Act, but the Supreme Court turned that decision over to the states.

"As we submitted our waiver extension request, the federal government, as it's looking at the changes under the Affordable Care Act has been reluctant to extend the waiver," said Michael Hales with the Utah Department of Health.

As it sits now, PCN is approved through next month, but Hales is confident the program will get funded through at least next year.

"It's very likely, we're just working through the final stages of the terms and conditions," said Hales.

Those terms and conditions could change based on what the state decides to do with Medicaid expansion.

"In the midst of this uncertainty about how the program is going to run and its federal authority we can't make any commitment after December, 2014," said Hales.

The uncertainty has Legge taking action, as much as he can anyway, given his bad back.

"I've called the governor's office and made my voice heard that way. I think they really need to hear the input of the people being affected the most, because we're the ones that will end up getting hurt," said Legge.

Thursday, the task force reviewing options for Medicaid expansion in Utah narrowed it down to three possibilities they will be focusing on, which doesn't include full expansion, as originally required in the Affordable Care Act.

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