In an attempt to address the hole in healthcare coverage created by the Affordable Care Act, the Utah House of Representatives has a number options to consider this year.
The ACA offers subsidies to those above the poverty level, while leaving many below uncovered, with the expectation that the states would expand Medicaid. Twenty-one states have chosen not to expand at this time. There remains substantial uncertainty about the sustainability of such a program and most states are unable to afford a Medicaid expansion even with the federal government’s offers to help.
As our legislature studies and debates the options, we’re fortunate to have in our midst a braintrust of lawmakers with significant expertise in various aspects of healthcare and healthcare policy. The vast experience and diverse opinions of these individuals will leave us feeling confident that any decision we make will have been well-considered and in the best interest of the citizens of Utah.
A representative since 2003, Representative Jim Dunnigan currently serves as Majority Leader in the Utah House of Representatives. He has chaired the legislative Health Reform Task Force for the past four years and has sponsored numerous pieces of legislation dealing with healthcare reform.
Dunnigan served as Chairman of the Governor’s Medical Payment Reform work group and the Governor’s Medicaid Expansion Oversight committee. He has presented before the National Institute of Medicine, as well as numerous conferences nationwide on health system reform.
Rep. Dunnigan Chairs the Health and Human Services Committee of the National Conference of State Legislatures Health Reform Task Force and is a member of the Children’s Health Insurance Advisory Board and the Council of State Government Nutritional and Hunger Task Force.
He has served as a board member of Selecthealth Insurance Plans, is on the Altius Broker Advisory
Board and is a member of the Leading Producers Round Table of the National Association of Health Underwriters. Dunnigan previously served on the Privately Owned Health Insurance Task Force, as well as the High Risk Health Insurance Task Force.
Dunnigan received his B.S. in Business Management from the University of Utah and is the owner of Dunnigan Insurance, an insurance agency with over 30 years of experience in health insurance and employee benefits.
Representative Francis Gibson currently serves as Majority Whip in the Utah House of Representatives.
He has been a healthcare administrator for over 16 years and as the current Director of Process Improvement for Intermountain Healthcare, he is tasked with eliminating waste and improving efficiency in the delivery of care to patients.
Gibson started his career as the Primary Care Administrator for a low-income, non-insured health care facility in Bryan, Texas. There he worked with nearly 20,000 patients annually who had Medicaid as their primary insurance or were uninsured and received charity care.
He later moved to Utah, where he was the CEO of two separate Ambulatory Surgery Centers and worked with many different types of patients, both insured and uninsured. Rep. Gibson has served as vice president of the Utah Ambulatory Surgery Center Association. In this capacity he worked with the Utah Health Department Office of Medicaid and the Office of the Inspector General.
His career has been focused on the delivery of healthcare, through payers in both the public and private sectors, and the delivery of the best possible care at the most appropriate cost continues to drive his mindset today.
Representative Dean Sanpei has acted as a consultant to companies around the country regarding healthcare policy and organizational structures. He has spent over 17 years analyzing, tracking and forecasting economic trends and impacts related to healthcare directions and policies.
Sanpei was a key participant in the reforming and developing of Utah’s Accountable Care structures and continues to be an industry expert in the complex components of healthcare delivery and systems.
Government Healthcare Policy
Representative Robert Spendlove has substantial experience in government healthcare reform and economics.
In 2007, he was appointed as the Governor’s Health Policy Coordinator by Gov. Jon Huntsman. Since then he has helped lead the effort to reform Utah’s healthcare system with the goal of reducing costs, improving quality and increasing access. With a background in economics, he has been actively involved in the process of modernizing Utah’s Medicaid system by making it more cost-effective and better able to serve those in need.
Representative Norm Thurston has a Ph.D. in economics with a specialization in health economics. After eight years of academic experience researching healthcare systems and markets, he joined the Utah Department of Health as a research consultant.
From 2005-2013, he served a variety of support roles to inform the State of Utah’s efforts to create state-based solutions for local healthcare issues. He has served as a policy adviser to the Utah Department of Health and the Governor’s Office, as well as Health Reform Implementation Coordinator for the state as it worked to implement the ACA in a way that would preserve as much state autonomy as possible.
In September 2013, Thurston took over as Director of the Office of Health Care Statistics – the agency responsible for collecting, analyzing and disseminating information about healthcare costs and quality for the State of Utah.
Representative Ray Ward, M.D., PhD. is a primary care physician in private practice. He has taught on the faculty of the Family Medicine Residency program at St. Mary’s Hospital in Colorado and has served as chair of the Family Medicine Department and on the Medical Executive Committee of Lakeview Hospital.
He served 4 years as the co-chair of the Utah Medicaid Pharmacy and Therapeutics Committee, tasked with getting the safest and most effective medications for Utah’s Medicaid population at lower costs to the state.
Because of his experiences with bad medical outcomes for patients who have not had access to needed healthcare or health insurance, Ward’s priority is finding a way to get coverage for basic health procedures for those Utahns below the poverty level who currently do not have access to medical insurance.
Representative Mike Kennedy, M.D. has been practicing medicine for 17 years. He received a law degree from BYU while working full-time in his medical practice. His experience as a medical practitioner has given him a unique perspective on many of the problems we face within our healthcare system.
Rep. Kennedy says that healthcare is one of the most regulated industries in the nation and at the base of policy considerations are the complex and personal interactions between the provider and the patient. As a physician, he has found that insurance and other influences have increasingly become involved in the decisions that patients and doctors make together.
According to Kennedy, “In one case, a patient of mine almost died because his government funded insurance refused to pay for a diagnostic test that would have identified his heart attack before he had a heart attack.”
He is most concerned with seeking solutions that allow patients and their healthcare providers, not bureaucrats and algorithms, to determine the course of the patient’s care and he will work to minimize intervening influences that interfere with that care.
Representative Stewart Barlow, M.D. is a board certified Otolaryngologist, Head and Neck Surgeon. He is a Board member and Co-founder of Davis Volunteer Free Clinic and has served as past President of the Utah Medical Association and as Co-Chair of Utah’s Vision 2010 Project: Committee for Affordable Medical Care for the Uninsured and Underinsured, in addition to service in various other organizations.
Rep. Barlow helped create the only Free Medical Clinic in Davis County, which has been servicing the county for nine years and is run by volunteer doctors, nurses and staff. He also helped create and form The Weber County Medical Foundation, which provides seed money to help start medical and community projects in Northern Utah.
Representative Edward Redd, M.D. practiced internal medicine in Logan for 16 years prior to serving as Deputy Director and Medical Officer of Bear River Health Department. He currently serves as Deputy Medical Examiner for the Cache County Coroner; off-line medical control officer for Cache County EMS; Cache County Jail physician; and Bear River Mental Health physician, providing outpatient and inpatient care for people suffering with mental illness.