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House approves changes to Utah CHIP that raise some cost-sharing to expand coverage
Summary
The House passed First Substitute HB218 to tie Utah’s Children’s Health Insurance Program benefits to a common commercial plan and raise certain co-pays and deductibles so the program can cover roughly 3,000 additional children without new net funding; supporters called it a modest cost-share to extend coverage, while opponents said the change is premature.
Representative James A. Dunnigan, sponsor of First Substitute House Bill 218, told colleagues the bill would change benefit structure to mirror the most commonly sold commercial market plan while preserving broad access for lower-income children. “The children's health insurance program provides health insurance coverage to children below 200% of the federal poverty level,” he said, noting the program now covers “over 35,000 children.”
Dunnigan said the bill gives the state flexibility to adjust co-pays and cost-sharing so that, without additional appropriation, the program can avoid dropping about 3,000 currently covered children. He described sample changes: a hospital visit co-pay rising from $3 to $5, a specialist visit co-pay increasing from $15 to $25, and the introduction of a $500 inpatient/surgical deductible for some enrollees. He emphasized that preventive care and immunizations would remain covered with no co-pays.
Opponents urged caution. Representative Litnak said the measure was “a premature move” and flagged a sharp shift in prescription coverage, noting that generic prescription cost-sharing would change from a $5 co-pay to a $125 deductible in some examples. Representative McGehee urged the body to reject legislative changes while the program administrator was already reviewing benefit changes, saying the department was proposing less extensive changes than the bill.
Supporters pointed to limited revenue options and rising costs. Representative Noble said tobacco settlement funding that historically supported CHIP has been largely used and that modest cost-sharing could preserve or expand coverage for additional children. Representative Neverell argued the bill would add coverage for thousands of children “with little or no cost” to the state’s general fund.
Voting was then opened, and the House recorded that First Substitute HB218 had received 53 yes votes and 17 no votes (absent: recorded as 25 in the floor announcement), and the bill was passed by the House and referred to the Senate for further consideration.
What happens next: The bill will go to the Senate for consideration and, if enacted, would require the health department to implement benefit changes consistent with federal CHIP requirements and the bill’s language. The sponsor said the department’s plan administrators (PEHP and Molina) would continue to administer the program; Molina was recorded as supportive in the floor remarks.
