Molina health insurance is leaving Utah's marketplace: What that means for thousands


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SALT LAKE CITY — Victoria Petro-Eschler wants good health care. But while Washington is in political limbo, she worries.

"I live in one of the best countries in the world and I'm having to worry about getting my son stitches," she said.

Petro-Eschler and her husband, Nathaniel Eschler, live in Salt Lake City. They run a nonprofit: the Salt Cricket's Composer Collective, with four concerts a year, and an immersive after-school music program. "We're an inseparable team in family and in work," Petro-Eschler said.

Even with the Affordable Care Act, the family's co-pays and premiums aren't exactly a song. "We're at a point in our family where we're looking at, 'How do we minimize even our need for health care? Do we really need to go to our doctor for physicals?'" Petro-Eschler said.

The Eschlers are one of the 70,000 Utahns with Molina Health Insurance who will have to find a new plan. The good news: University of Utah Health Plans (UHPP) is expanding statewide, moving into 13 new counties. All Utahns should have two choices for 2018.

The bad news: Rates are going up.

The Eschlers' oldest son "just did what all kids do by the time they're 6 years old on a playground, he busted his head open," Petro-Eschler said. Her co-pay for urgent care is $60, and her co-pay for the emergency room is $400. "I made my son with a bleeding head, after we controlled it, wait while I tried to call around and find an urgent care," she said.

The Affordable Care Act provides premium subsidies for 86 percent of Utahns on the marketplace, that's 170,000 people. But the Trump administration may get rid of those subsidies, something advocates are lobbying to keep.

The stress has the Eschlers feeling panicked.

"God forbid, what happens to us if we get in a car wreck? Let's not even talk about cancer," she said. Nathaniel Eschler said, "That puts a tremendous amount of anxiety on our family and on me."

They are not alone. Many families are feeling the squeeze. A few tips can help. When shopping around, experts say most people mistakenly look at the monthly premium first.

"That can be deceptive," said Jason Stevenson with the Utah Health Policy Project. "Because if you have a low monthly premium and a high deductible and you don't realize that, you're going to be surprised that first time you go to the doctor."

He recommends doing your homework. "One of the trickiest things is doctors. You know, 'Is this doctor going to be in my network? Is this hospital where I delivered my babies going to be in my network?'" Call up your doctor and say, 'Hey, do you take X,Y,Z insurance and double check and make sure it's the exact insurance that you're buying," Stevenson said.

Along with rates, subsidies will also go up. And UHPP offers free help navigating the marketplace. Now that's something to sing about.

Starting Nov. 1, you can get free, personalized enrollment help from experts across the state at www.takecareutah.org or by calling 211. Also, the open enrollment period is shorter this year and ends Dec. 15.

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Heather Simonsen

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