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HCA staff outline options for closing UMP Plus as part of budget reductions
Summary
Health Care Authority staff told the board that closing the UMP Plus plan is on the table in governor-driven budget scenarios; staff highlighted possible member impacts (deductible and network differences), automatic mapping plans, and communications plans if the legislature adopts the change.
Health Care Authority staff presented the board with scenarios tied to the governor's budget that include a possible early closure of the UMP Plus plan and described how members would be moved to comparable coverage if the legislature adopts the change. Staff stressed the decision would be part of the final budget process and is not an immediate board action.
Dave Price, a Health Care Authority staff member who led the presentation, said that the agency expects roughly "42,000 between the PEP and SEP programs and a little over 30,000, within just the PEP program, Tom" could be affected by a plan closure and that any mapping to alternate plans would be done with an eye to premium and cost-share comparability. He added that UMP Plus members would gain access to broader network features and the centers-of-excellence program for certain surgeries, but could face higher deductibles if moved to other plans.
Staff walked the board through the consumer-facing tradeoffs: UMP Plus has lower deductibles in many cases and specific primary-care benefit features that other UMP options do not, while other plans offer wider provider networks. Staff also described the agency's planned communications approach: targeted letters, email pushes for subscribers who opt in, benefits fairs and automatic "mapping" to a default plan for members who do not make an affirmative election.
Board members pressed staff on the cost drivers and communications. Tom McRobert asked about the likely minimum increased out-of-pocket cost for moved members; staff said illustrative calculations suggested a minimum increase of several hundred dollars annually for some members while noting there would also be premium differences that could offset some of that cost. Staff emphasized the final path depends on the legislature's decisions and the timing of collective bargaining commitments that constrain earlier implementation dates. The agency said, if the closure were adopted in a final budget, implementation would likely be timed to align with plan-year and bargaining timelines rather than be immediate.
The board did not vote on a plan closure at the meeting; staff committed to return with further modeling and communications plans if the legislature includes the item in a budget they submit to the governor.
