Medicaid

BROAD COALITION CALLS FOR INVESTMENT IN UTAH’S FUTURE RATHER THAN TAX CUTS, DOCUMENTS $5.6 BILLION IN URGENT UNMET NEEDS

Salt Lake City – On Monday, January 23, 2023 at the Utah State Capitol, a broad and diverse coalition of advocates for the poor, for disabled Utahns, for education, health care, clean air, the Great Salt Lake, transportation investment, and a variety of other popular Utah priorities held a press conference calling on the Utah Legislature to prioritize addressing Utah’s long and growing list of unmet needs over permanent tax cuts that undermine our long-term capacity to invest in Utah’s future.

Utah’s strong economy and rapid recovery from the pandemic, combined with the ongoing impact of federal spending, have generated unexpected state revenues amounting to a reported $3.3 billion available for FY2024. These revenues put Utah in a position to address chronic revenue shortages that have plagued numerous areas of state responsibility. Instead, state leaders have proposed roughly half a billion dollars in permanent tax cuts, tilted unfairly toward the high end of the income scale, as well as additional hundreds of billions in one-time tax breaks.   

These new proposed permanent tax cuts would be over and above the roughly $4 billion that the Legislature has already cut from annual revenues in recent decades, leaving Utah’s taxes at their lowest level in half a century, relative to incomes.

4b tax cuts since 1985 CANVA 2048x1381

In response, today the Invest in Utah’s Future coalition presented a list of urgent unmet needs amounting to $5.6 billion, over $2 billion more than the amount of the “surplus” revenues.

The advocates also pointed out that, according to data from the Utah State Tax Commission and the Utah Foundation, taxes in Utah are the lowest that they have been in decades, following repeated rounds of tax cutting. “Of course we all like paying lower taxes, but at a certain point we have to ask ourselves: Is it possible to have too much of a good thing? Are we, as the current generation of Utahns, meeting our responsibility, as earlier generations did, to set aside sufficient resources every year to invest in our children, in our future, in the foundations of the next generation’s prosperity and quality of life?” said Matthew Weinstein of Voices for Utah Children.

Speakers also referenced public opinion surveys by the Deseret News and Hinckley Institute that found that only 25% of Utahns support tax cutting over investing in Utah’s future, consistent with other polls done in recent years by the same organizations as well as by Envision Utah and the Utah Foundation.

Here is the list of urgent unmet needs that Utah has not been able to address due to the state’s chronic revenue shortages:

 Budget Area Amount Details Contacts
 K-12: Reduce class sizes from 29 to 15  $1.1 billion ($612m K-6 only)  

Reduce class sizes/improve student/teacher ratio below the current Utah average of 29 (vs national average of 24) to optimum class size of 15.

Utah Education Association Director of Policy and Research Jay Blain
 K-12: Paraeducators   $312 million  

Expand paraeducators to all Utah elementary classrooms.

Utah Education Association Director of Policy and Research Jay Blain
 K-12: Increase school counselors   $130 million  Increase school counselors per student to the national standard optimum of 1:250. Utah’s current ratio is 1:648, compared to the national average of 1:455.    Utah Education Association Director of Policy and Research Jay Blain
 K-12: school psychologists, social workers and special ed teachers  $285 million Increase student access to school psychologists, social workers and special ed teachers. 

Current and optimal ratios are: 

School psychologists: Now 1:1950/Optimal 1:500

Social workers: Now 1:3000/Optimal 1:250

Special ed teachers: Now 1:35/Optimal 1:25
Utah Education Association Director of Policy and Research Jay Blain
 K-12 Education: reduce teacher attrition and shortages  $500-600 million  Envision Utah estimates that we need to invest an additional $500-600 million each year just to reduce teacher turnover, where we rank among the worst in the nation. Our leaders’ unwillingness to solve our education underinvestment problem is why the majority-minority gaps in Utah’s high school graduation rates are worse than nationally and our younger generation of adults (age 25-34) have fallen behind their counterparts nationally for educational attainment at the college level (BA/BS+).   
 K-12 School Nurses  $78.5 million The Utah Dept of Health annual report “Nursing Services in Utah Public Schools 2021-22” found that it would cost $78.5m to hire an additional 785 nurses so as to have one nurse in every public school building. There are currently only 261 nurse FTEs in Utah’s public schools, a ratio of 1 nurse for every 2,583 students. One nurse in every building would improve that ratio to 1:644, which would still be worse than the national average.
https://heal.health.utah.gov/wp-content/uploads/2022/08/2022-Nursing-services-in-Utah-Public-schools-8-22-22-ADA.pdf
 Dr. William Cosgrove, Past-President, American Academy of Pediatrics – Utah
 Full Day Kindergarten  $70 million  Gov. Cox is proposing $70 million in the FY24 budget to make full-day Kindergarten available to all Utah families who would choose to opt in to it.  Voices for Utah Children Anna Thomas
Child Care $236 million

$236 million is needed to continue stabilizing the child care industry as federal funds are depleted. This funding will allow for the continuation of child care stabilization grants, retention incentives for early childhood professionals, the coverage of licensing-related fees in order to lessen the barriers to expanding, maintaining, and opening new child care programs, and regional child care outreach grants for rural and urban child care deserts.

Source: www.utahcareforkids.org/get-involved/2023-legislation

Jenna Williams  

Pre-K and Child Care $1 billion Well over $1 billion is one estimate for a much needed comprehensive system of early childhood care and education (pre-k) in Utah.  
Afterschool Programs $3.6 million Utah’s 303 afterschool programs serve 43,000 kids but still leave 99,000 unsupervised every day after school. During the 2021 “21st Century Community Learning Center” grant competition in Utah, $1,062,816 was available and there was $4.6 million in requests, indicating a $3.6 million funding gap. Utah Afterschool Network Director Ben Trentelman 
Health Insurance: Children: Cover All Kids $5 million It would cost Utah about $5 million to remove barriers to health insurance coverage so that all Utah kids can access health insurance. Utah currently ranks last in the nation for covering the one-in-six Utah kids who are Latinx and in the bottom 5 states for all children. Source: Voices for Utah Children and www.100percentkids.health Voices for Utah Children Ciriac Alvarez Valle

Health Insurance:

New parents
$10 million

HB 84 would cost $3m to extend post-partum Medicaid coverage for new parents from the current 60 days to one year.

HB 85 would cost $7m to extend Medicaid coverage to pregnant women with household incomes up to 200% of poverty level.
Voices for Utah Children Ciriac Alvarez Valle
 Mental Health & Substance Use Disorder Treatment Uncertain 

Utah ranks last in the nation for mental health treatment access, according to a 2019 report from the Gardner Policy Institute.

2020 report from the Legislative Auditor General found that Utah’s Justice Reinvestment Initiative had failed to achieve its goal to reduce recidivism -- and actually saw recidivism rise -- in part because “both the availability and the quality of the drug addiction and mental health treatment are still inadequate.” (pg 51)

Amounts not determined to address large gaps in workforce capacity, but two bills this year are:  

HB 66: $11m for additional Mobile Crisis Outreach Teams and 2 additional Receiving Centers in rural parts of Utah

HB 248: $5m for additional Assertive Community Treatment Teams
 
 Disability Services  $31 million

The DSPD disability services waiting list has more than doubled in the last decade from 1,825 people with disabilities in 2011 to 4,427 in 2021. The FY20 $1 million one-time appropriation made it possible to provide services to 143 people from the waiting list, implying that it could cost $31 million to eliminate the waiting list entirely. 

In the 2022 session, the Legislature added $6 million in ongoing and $3 million in one-time money to shorten the disabilities waiting list. This year, Rep. Ward is sponsoring HB 242 to dedicate additional base budget funding to reduce the waitlist by 200 people each year.
 Legislative Coalition for People with Disabilities – Jan Ferre  
 Rural Utah Economic Development $20 million   Rural Utahns should not feel that they need to abandon their home communities and add to the growth pressures along the Wasatch Front in order to provide for their families. Rural economic development would benefit all Utahns and reduce disparities between the Wasatch Front and other areas of the state. $20 million was one estimate for funding for economic development projects like the San Rafael Energy Research Center (Emery County) and renewable energy projects around Beaver County, both serving areas where primary jobs such as Smithfield Foods have left recently, and renewable energy projects have the potential to stabilize county economies.   Community Action Partnership of Utah - Stefanie Jones and Clint Cottam –  
 Reduce/Eliminate Benefits Cliffs  Uncertain  The existing benefits cliffs in many public anti-poverty programs – where public assistance disappears suddenly rather than phasing out gradually when someone gets a raise or takes a new, higher-paying job – act as an unintended obstacle to the efforts of low-income people to work their way out of poverty.   Circles Salt Lake – Kelli Parker
 Sexual and Domestic Violence Victim Services  

$310 million

OR

$68 million
 

Our economy incurs steep economic costs as a result of sexual and domestic violence. The Center for Disease Control estimates that over a lifetime the costs for a female survivor are $103,762 and for a male survivor $23,414. These include medical costs, loss of employment or interruption of paid work, criminal justice system costs, among others. A coalition of victim service providers and state agencies estimates the annual funding needed as $310 million ongoing to meet standard of care for all victims of domestic and sexual violence OR $68 million ongoing to fund the most basic level of services at only the current level of demand for services.

Erin Jemison, Director of Public Policy, Utah Domestic Violence Coalition (UDVC)
 Housing  $346 million per year for 10 years  

Among extremely low-income renter households, 71% pay more than 50% of their income for housing, which is considered a severe housing burden. $346 million per year of state funding over the next decade will make it possible to build affordable housing  statewide for people earning less than 50% AMI, based on a state cost share of $80,000 per unit, and Utah is short 43,253 units.

For more information on the current and ongoing needs visit https://nlihc.org/gap/state/ut 

Utah Housing Coalition

Tara Rollins  
 Housing for Seniors  $67.5 million  

$37.5 million a year for 10 years will fund rehabilitation of 500 units per year at a cost of $75,000 per unit. If we don’t fund preservation of affordable housing for seniors we will lose valuable units.

$30 million per year will make available rental gap funding of $500 per month for 5,000 units so that seniors can afford to stay in their rented units.

https://www.utahhousing.org/preserving-senior-affordable-housing-report.html 

https://nyuds.maps.arcgis.com/apps/webappviewer/index.html?id=b8318f874017488ea9bdd51a296e59ef for senior housing report
Utah Housing Coalition Director Tara Rollins
 Homeless Services  $154 million 

$100m in one-time funds to produce 2,000 units of deeply affordable housing

$19m ongoing for tax credits and housing trust fund

$5m to the housing trust fund to produce 1,000 new units of affordable housing over the next 10 years

$30m one-time for projects to eliminate unsheltered homelessness for families with children: The total number of people needing emergency shelter services in Utah increased by 14% in 2022.  For families with children the increase was 33%.  This is why, for the first time in over 20 years, families with children were turned away from the family shelter in Midvale during the months of September, October and November of last year because there were not enough beds to meet the need.  $30 million would help purchase a motel to convert into a second family shelter and purchase land that can be dedicated to produce mixed income housing developments that include permanent supportive housing for families with children headed by parents with disabling conditions that have been homeless for six or more months.
 

Coalition of Religious Communities - Bill Tibbitts

 Air Quality in Schools $5 million  Funding to continue the successful implementation of this year’s federally-funded program placing air purifiers in every classroom in Utah, which will reduce the risks both from COVID and from Utah’s air pollution and is expected to result in improved school performance, even more than standard interventions such as reducing class size by 30%, or “high dose” tutoring. (Source: Utah Physicians for a Healthy Environment) UPHE Director Jonny Vasic -
 Air Quality: Promote Transit $25.5 million  

The Utah Transit Authority (UTA) experienced an increase in ridership during Free Fare February in 2022. Tens of thousands of riders, including many new to public transit, enjoyed the services, and stress on our transportation system and environment was lessened.

Governor Cox’s Budget Recommendations for FY24 includes a $25 million, one-year pilot for statewide zero-fare transit. This pilot would include the state’s three transit systems that are not currently zero-fare: Cedar Area Transportation System, SunTran, and the Utah Transit Authority. The governor also recommends $500,000 for a zero fare transit study to analyze the impacts of the pilot.

During Free Fare February, 87% of entities that subsidize UTA fares for their users continued paying subsidies to help enable the zero fare period. The Governor’s proposal calls on UTA fare subsidy partners to continue paying subsidies for their users during this one-year pilot period to cover $13.1 million in additional costs.

This pilot will provide Utah families price relief to help offset the burden of gasoline prices, gasoline tax indexing, and inflation, while also allowing researchers to analyze factors related to permanent decisions about zero fare transit

Steve Erickson -

 Improve UTA transit service   $175.6 million

$10.9m to match UTA projections to fully supplement free fares for a year. (In all, UTA projected $35.9 in fare revenue for 2023)

$3.5 million to address UTA’s driver shortage ($20/hr*2,080 hours*60 operators + 40% for benefits, taxes, etc.)

$30,000 to match CATS (Cedar City’s transit system) to fully supplement free fares for a year based on budget projections.

$136,000 to match SunTran (St. George’s transit system) to fully supplement free fares for a year based on budget projections.

$159 million to clear UTA’s debt to free UTA to expand and improve service.

$2 million to fund a matching grant from the federal government to study the feasibility of a passenger rail route connecting Boise to Las Vegas via Salt Lake and points in between.
 Curtis Haring, Utah Transit Riders Union    
 Hunger $1 million  It is clear that the state needs to do more in providing funding and other resources to help support local community food pantries. Utahns Against Hunger – Gina Cornia –
 Utah EITC  $57 million  Last year Utah became the 31st state with our own Earned Income Tax Credit, but we're one of the few who make it non-refundable, even though over 85% of the value of the federal EITC -- and the key to its poverty-reducing and workforce-enhancing power -- is its refundability. In 2022 under Gov. Youngkin, Virginia made their state EITC refundable. ITEP analysis shows 71% goes to the lowest-earning quintile and nearly all to the lower-income half of Utahns.   Voices for Utah Children – Matthew Weinstein –  
Gov. Cox’s proposed refundable tax credit   $54 million  Utah's Taxpayer Tax Credit shields most low-income workers from the income tax, which is a good thing because it makes our overall tax system less regressive. Now Gov. Cox is proposing to make it even better by making up to $250 of this credit refundable.  Drew Cooper, United Today Stronger Tomorrow
Eliminate the sales tax on unprepared food $200 million The food tax is the most regressive tax. One-third of it is paid by the lowest-income half of Utah households, who earn less than a sixth of all Utah income. According to the U.S. Department of Agriculture’s Economic Research Service, low-income families pay 36% of their income on food while higher-income families spend only 8%. This is why 37 states do not charge any sales tax on food. Drew Cooper, United Today Stronger Tomorrow
Save the Great Salt Lake $333 million Gov. Cox is proposing $133m in new resources to save the Great Salt Lake and $200 million to help reduce water waste in agriculture. Source: www.sltrib.com/news/2022/12/30/dear-legislature-heres-2023/ Utah Rivers Council –Matt Berry
Racial Equity, Diversity, and Inclusion as it relates to undocumented Utahns   Our public fiscal policies – how we generate and expend public investment dollars – have a direct impact on whether we are widening or narrowing the gaps between different groups in Utah. The Utah Compact on Racial Equity, Diversity, and Inclusion must be more than just words on a page. slchamber.com/public-policy/utah-compact In particular, Utah is home to 95,000 undocumented men, women, and children. They work hard and pay taxes and need and deserve access to the same public services as every other Utahn. Comunidades Unidas – Brianna Puga –
The economic case against tax cuts   Tax cuts are usually enacted to provide additional stimulus to the economy. Given our very low unemployment rate, along with ongoing inflationary pressures, now is not really the right time for new economic stimulus. The future is uncertain – some economists expect we may face a recession in the coming year, though there’s a wide variety of opinions about the likely timing and severity of such a possible event. Additional tax cuts right now won’t do much to affect that. However, investing now in the many unmet needs we face, particularly in the areas of water and climate, education, child-care, and the many other needs listed here this morning, will put us in a better position to thrive whatever the coming years bring us in terms of economic conditions. Univ. of Utah Economics Prof. Thomas Maloney PhD

 TOTAL

 

$5.6 billion – over $2b more than the amount of "surplus" revenue for FY2024

 

 

 The press conference was broadcast live on Facebook: https://fb.watch/ieyT_0Zi14/?mibextid=RUbZ1f 

INVEST press conf FB screenshot

Media coverage: 

 Additional one-pagers distributed by some of the coalition members: 

Published in News & Blog

Families living with health insurance, and without: New storybook highlights why all Utah children need health insurance

Throughout the pandemic, health insurance has been a critical lifeline for Utah families to stay healthy and avoid medical debt. Yet many Utah children and parents are still unable to access any form of health insurance; they are denied coverage due to their immigration status. A new digital storybook, released by Voices for Utah Children, highlights families’ real-life experiences with health insurance and medical care. The stories reveal how having health insurance- or not having it- can alter a child’s life course.

The digital book is a collection of accounts shared by children, parents and caregivers across Utah. To protect the privacy and sensitive material shared, names were changed. The book includes accounts of children growing up without health insurance; the short and long-term positive impact of CHIP and Medicaid for children; immigrants and asylees finding the care they need; and children being denied care due to immigration status, while their siblings born in the United States can access care.

The storybook humanizes a problem that is often ignored: today in Utah, thousands of Utah children are still shut out of health coverage. As one DACA- recipient recounts in the book, growing up her families was “Too scared of the cost to go to the ER.”

However, there are glimpses of hope on the horizon. In the 2022 General Session, the Utah Legislature considered a bill that would allow all income-eligible children to enroll in Medicaid or CHIP, regardless of their background or immigration status. The bill, sponsored by Senator Luz Escamilla and Representative Mike Schultz, passed the Senate with broad support, but ran out of time in the House.

The book lifts up the stories behind the 2022 legislation. Previous reports from Voices for Utah Children have estimated the significant state savings if all children have coverage. The digital storybook shows the emotional, physical and financial costs families pay when their children are denied health insurance, and the life-changing benefits when families are able to get coverage.

Download Storybook Today!

Published in News & Blog

This Session, one of Voices for Utah Children’s top priority bills received very little public attention despite its behind-the-scenes activity. Below we will unpack what happened, lessons we learned, and what we believe the path forward should be so we can reach 100% Kids Coverage in Utah.

First a little background, during the 2021 Legislative Session, we were thrilled to see many statements in support of children’s health insurance coverage. Speaker Wilson highlighted children’s coverage and Utah’s high rate of uninsured kids during his opening Session remarks and supported funding for CHIP outreach. On the Senate side, Senator Escamilla championed a bill to Cover All Kids, which former House Leader, Representative Gibson, sponsored on the House side. While the bill did not make it through in the final days of the Session, it seemed well-positioned to pass in 2022.

Onto 2022…

This year Senator Luz Escamilla ran Senate Bill 185. Like her bill last year, SB 185 ensured all Utah children could get covered and stay covered by allowing income -eligible Utah children access to Medicaid and CHIP, regardless of immigration status. In addition, SB 185 restored funding for continuous eligibility for Medicaid children. Senator Escamilla skillfully navigated SB 185, with approval from the Senate Revenue and Taxation Committee and broad support on the Senate floor. On the House side, Majority Leader, Representative Mike Schultz, stepped up as the House Sponsor to usher the bill across the finish line. But unfortunately, the bill was never brought to the full floor for a vote in the House.

So what happened this year?

Although SB 185 made it out of the Senate with little objections or pushback, it ran into obstacles in the House. The bill arrived in the House without enough time for a committee hearing. While it could have gone through without one, members of the House did not have the full time to discuss and familiarize themselves with the bill and work through question or concerns.  Although the bill never came to the floor for a full vote, it did have strong bipartisan support. Cover All Kids got even closer this year, but still fell short.

Going forward, we must discuss any questions or concerns directly. We invite lawmakers to join us in having honest conversations about the children we are leaving behind in our state, the children we are deciding not to cover. All children growing up in Utah need health insurance to thrive, regardless of their immigration status. To deny some children access to health care is unconscionable.

It is time we amplify the many voices, the stories, the statewide energy and support for Covering All Kids.  Lawmakers are ready; Utahns are ready. It’s time we act to Cover All Kids.

Learn more about the stories and join our campaign at https://www.100percentkids.health/take-action

Published in News & Blog

Utah has 82,000 uninsured children, according to the most recent Census data, which means an estimated 8.3% of children in Utah do not have health insurance. Utah currently ranks 46th in the nation for insured children.

When it comes to addressing this problem, too often public debate focuses on the cost to taxpayers of insuring Utah’s 82,000 uninsured children. But what about the cost of not insuring children?  Are there ways in which Utah taxpayers are already paying a price for allowing such a high number of uninsured children in our state?

In our new report, we address this question, building on findings from previous research. We explore two key ways in which Utah taxpayers are paying millions of dollars in costs annually for uninsured children:

1)  Uncompensated care for Utah’s 82,000 uninsured children may be costing state and local governments in Utah about $8.8 million annually.

2)  Covering all of Utah’s uninsured children would likely result in higher educational attainment levels, potentially adding nearly $10 million to Utah's personal income annually and generating over $800,000 in new tax revenue each year.

In sum, our report finds that Utah may be losing out on at least $9.6 million every year because of our high child uninsured rate.
 
We hope state leaders and policymakers will consider these findings as they review proposals to help improve Utah’s child uninsured rate. We can, as a state, remove barriers to Medicaid and CHIP.  We can adopt policies to help the thousands of Utah children unable to access health insurance.
 
These state proposals have costs, but the status quo is costing us even more. Our failure to act is undermining our state’s economy and holding back 82,000 children from achieving their full potential. As a state, we can no longer ignore the costs when thousands of children are uninsured and the profound savings when all children have coverage.
 

VIEW | DOWNLOAD Report

 

report graphic 1

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Salt Lake City - Voices for Utah Children released publicly today (January 6, 2021)  "#InvestInUtahKids: An Agenda for Utah's New Governor and Legislature," the first major publication of our new #InvestInUtahKids initiative. 

Utah begins a new era in this first week of January, with the swearing in of a new Governor and Lt. Governor and a new Legislature. The arrival of 2021 marks the first time in over a decade that the state has seen this kind of leadership transition. Last month Voices for Utah Children began sharing with the Governor-elect and his transition teams the new publication, and on Wednesday morning Voices will share it with the public as well.

The new publication raises concerns about the growing gaps among Utah's different racial, ethnic, and economic groups and lays out the most urgent and effective policies to close those gaps and help all Utah children achieve their full potential in the years to come in five policy areas: 

  • Early education 
  • K-12 education 
  • Healthcare
  • Juvenile justice
  • Immigrant family justice

The report, which was initially created in December and distributed to the incoming Governor and his transition teams, closes with a discussion of how to pay for the proposed #InvestInUtahKids policy agenda. The pdf of the report can be downloaded here

Published in News & Blog
July 30, 2020

Children’s Health

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