This is an archived article that was published on sltrib.com in 2015, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Compromise and open debate to address longstanding problems are seldom used by our representatives in Washington. The Affordable Care Act (ACA) is good example.

Health care costs have been out of control for more than two decades, and when our elected representatives had the opportunity to work together to address this problem, they chose not to. Out-of-control health care costs have added staggering amounts to the federal deficit and made health care unaffordable for most Americans. How much more effective would the ACA have been if both parties worked in concert to solve a long standing problem?

Sen. Orrin Hatch's recent op-ed considers the ACA a failure. Let's review the positive and negative aspects of the ACA. It stopped insurers from denying coverage due to a pre-existing condition. Insurers can no longer charge sick people higher premiums. Women no longer have to pay a higher premium than men. CNN recently reported that "16.4 million individuals have gained health insurance coverage since the ACA became law. About 2.3 million adults under 26 have coverage because they were able to remain on their parents' plan."

It's important to understand these same people used to get their health care needs in the emergency room and the costs were passed on by providers to those with health insurance. This cost shift added as much as 15 percent to our premiums. It's also important to understand that if there were no tax incentives or penalties, insurers would choose not to be offered on the exchanges. If insurers could no longer deny coverage or charge the unhealthy higher premiums, they would only have sick people in their risk pool.

The ACA has been very successful in providing affordable access to health care. It has been a failure when it comes to providing incentives to employers to provide coverage to its employees. Small and midsize employers should have been given more accessible tax credits to provide coverage, and not penalized when they chose not to provide coverage.

The ACA's biggest failure is not addressing why health care costs have been out of control. I have believed for a very long time competition cannot provide the best quality at the lowest cost if consumers do not know what something costs before they purchase it. Price transparency for health care can now be achieved with today's technology, and our elected representatives should put in place systems that provide that transparency.

Hatch claimed that the CO-OP program has been so severely mismanaged that thousands of families across the country now find themselves without health insurance.

He also commented on Arches Health Plan and why he thought it had to close its operation. He stated that CO-OP insured members no longer have coverage.

I appreciate Hatch's comments because it gives me the opportunity to present additional facts. Arches exchange members have coverage until the end of the year, and in the meantime, members can go to the exchange and enroll with a Utah carrier

He stated many of the executives running these CO-OPs are political activists with no prior business background. Four of Arches key executives had more than 120 combined years working in the health care industry. Arches' chairman was the former deputy insurance commissioner. Arches physician board member was the executive director of the Department of Health for Gov. Jon Huntsman. All but two of Arches board members were working with or for the health care industry.

Why did Arches have to close its operations? Arches and other CO-OPs closed operations due to a lack of required ACA funding from the Centers for Medicare and Medicaid Services (CMS). Insurance Departments in each state require reserves based on an insurer's membership. CO-OPs were required to be offered on the exchanges.

As it turned out, many CO-OPs had a growth in membership that outstripped their reserves, and CMS ran out of funds to cover their solvency-reserve requirements. Initially, Congress appropriated sufficient funds to cover these reserves, but the amount to fund CO-OPs was cut in half. In addition, every single member of Utah's congressional delegation voted for a Cromnibus bill last December that retroactively cut funding for ACA programs by 87.4 percent. This was not a problem for existing large insurers, but Arches and others had to close operations when the funding for the expected high claims costs for exchange members was withheld.

For example, Intermountain Healthcare's plans lost more money for each exchange member than Arches. There were three programs offered by CMS to cover these expected loses. For example, one of the programs was to cover any claims that exceeded $45,000 up to $250,000. When it came time for the government to pay insurers in September, they only paid 12.6 percent of what they owed. Large insurers could wait for the remaining funds to be paid over time, but it caused a serious cash flow problem for start-up insurers like Arches.

The CEO of Aetna was so angry by the lack of a timely payment he stopped Aetna from participating on the Utah exchange. CMS mismanagement and our elected representatives have to take some responsibility for this funding shortfall and the closure of Arches Health Plan.

Linn Baker worked in the health care industry with both state and national healthcare organizations. He was the director of the State of Utah's Public Employees Health Program (PEHP) for 31 years. This past June he retired as CEO of Arches Health Plan.