Health

100% Kids Coverage Campaign & Coalition Launch

Giving All Kids the Opportunity to Thrive

FOR IMMEDIATE RELEASE

Wednesday, May 22, 2019

CONTACT:

Ciriac Alvarez Valle

801-364-1182

Salt Lake City —A coalition of over 20 diverse stakeholder organizations will announce a campaign aimed at ensuring that all Utah children have health care coverage, regardless of background, geography, immigration status, or income this Friday, May 24^that 10 am at the Voices for Utah Children office (details below).

Utah has one of the highest uninsured rates for children in the country. In the last year, Utah was one of only 9 states to see an increase in its child uninsured rate, up from 6% to 7%. Children of color and immigrant children are disproportionately affected, of the 71,000 children without health insurance, almost 43% are Latino children. The Campaign aims to reduce the disparities in coverage and ensure that every child has the ability to access affordable health coverage.

During the launch, Voices for Utah Children will share its new State of Children’s Coverage Report with detailed information regarding Utah coverage, disparities to care and barriers faced by immigrant families. The 100% Kids Coverage Campaign focuses on four main policy priorities: Protecting and fully expanding affordable coverage for parents and pregnant women; keeping kids covered all year round; helping families connect and stay covered; and covering all kids regardless of immigration status. More detailed information about the campaign can be found here: https://utahchildren.org/issues/100-kids-covered.

The report includes several stories and testimonies from immigrant families on the importance of health insurance. “If [our family] had medical insurance, I’d be a calmer woman, with less stress, and more happiness because I’d have my son in his therapies that he really needs,” said one Utah mother in the report.  

 “Our campaign is committed to ensuring that Utah is a place for all children to grow up healthy, regardless of immigration status,” said Ciriac Alvarez Valle, Health Policy and Community Engagement Fellow for Voices for Utah Children. “We are encouraged to have so many groups come together in support of getting Utah to 100% Kids Coverage.

The Campaign & Coalition Launch will be held on Friday the 24th at 10:00 AM at the Voices for Utah Children Office (747 E South Temple #100).

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New report Finds Medicaid Expansion Leads to Healthier Mothers and Babies

 A new report shows states that fully expanded Medicaid saw a sharp decline in the uninsured rate for women of childbearing age. Utah’s uninsured rate for women ages 18-44 was at 11.2 percent in 2017, according to a new report by the Georgetown University Center for Children and Families. In comparison, states that had implemented full Medicaid expansion had an average uninsured rate of only 9 percent. Utah recently received a waiver to begin partially expanding its Medicaid program. More Utah women will now be eligible for Medicaid coverage; however, following the decision of the Legislature and Governor to roll back the voter-approved expansion, thousands of residents will still remain without the health coverage they need, including prenatal care.

Medicaid expansion has played a key role in reducing rates of maternal death, decreasing infant mortality rates, and improving the potential for optimal birth outcomes that can increase the promise for a healthy childhood, according to the report. States that fully expanded Medicaid saw a 50 percent greater reduction in infant mortality, compared to non-expansion states.

“Health coverage before, during, and after pregnancy is essential to the health and well-being of both mother and child,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “Medicaid expansion is the single most effective way to help women of childbearing age get continuous health coverage during this critical stage of life.”

States that have expanded Medicaid have also decreased the likelihood that women’s eligibility for coverage fluctuates, resulting in losing and regaining coverage over a relatively short span of time. Breaks in health coverage, also known as “churn,” can disrupt care and cause existing health conditions to become more serious and more difficult and expensive to treat, according to the report.

“The message of this study is clear: Medicaid expansion can protect the lives and health of women and their babies, especially women of color who are at higher risk for a range of poor outcomes,” said Dr. Rahul Gupta, Senior Vice President, and Chief Medical and Health Officer at March of Dimes. “If mom isn’t healthy, then her baby is at higher risk for a whole host of health consequences. If she’s healthy, however, that baby has a much higher likelihood of getting the best possible start in life.”

The American College of Obstetricians and Gynecologists recommends that women have access to continuous coverage prior to becoming pregnant and 12 months postpartum to reduce preventable adverse health outcomes.

“OB-GYNs have long recognized that continuous, quality and affordable medical care is vital to the health and wellbeing of our patients,” said Barbara Levy, M.D., Vice President of Health Policy at ACOG. “This important research demonstrates that Medicaid expansion plays a critical role in reversing the steadily rising rates of maternal mortality in the United States by ensuring women have access to the care they need before, during and after childbirth. As many as 60 percent of maternal deaths are preventable. Therefore, ACOG encourages both expansion and non-expansion states to continue working toward Medicaid policies that fill the gaps in coverage to improve health outcomes for women and babies.” 

Research shows that health coverage prior to pregnancy helps address risk factors such as obesity, diabetes and heart disease and improves access to timely prenatal care. In Utah, new mothers typically lose Medicaid coverage 60 days postpartum. When mothers abruptly lose health coverage so soon after giving birth, it can force women to abandon medication or other ongoing treatment they may need, including support for postpartum depression, which can affect up to one in seven Utah women.

“As Utah begins implementing its partial Medicaid expansion, we know that there is more we can and need to do to make affordable health insurance available to all Utah residents.” said Jessie Mandle, Senior Health Policy Analyst with Voices for Utah Children. “When women are shut out of affordable coverage because they do not qualify for Utah’s partial expansion, or because they experience disrupted care, this impacts the whole family. This report makes clear that full Medicaid expansion, without caps, barriers or disruptions, is critical for the health and well-being of Utah moms and kids.”

See the full report: https://bit.ly/2JPfa9N

Healthy kids do better in school. Research shows that school-based care plays a critical role ensuring kids can stay healthy and learn. Thanks to collaboration and vision from our state leaders, Utah is making strides to help more children connect with care at school.

• During the 2019 Legislative Session, schools received new funding to increase school-based mental health services, including school nurses. School nurses can help identify a mental health condition before it escalates and connect kids with appropriate care.
• Utah is one of a handful of states currently exploring innovative ways to leverage Medicaid funding in schools. By leveraging Medicaid, schools could access additional funding to offer preventive health services such as dental care or mental health services.
• Schools help enroll kids in affordable health insurance. School-based Medicaid/ CHIP outreach and enrollment support is one of the most important ways kids can connect with coverage. Learn more about getting enrollment support at your school!
• School-based clinics, or school-based health programs, are critical ways to help kids access care. For example, school-based oral health programs help ensure kids get preventive dental care. Oral health pain is one of the top reasons kids miss school. New policies, such as teledentistry reimbursement, can ensure the long-term sustainability of school-based health care programs.

Learn more about...

• How newly eligible people can enroll in Medicaid and how you can help connect families with coverage.
• What’s happening with Utah’s waiver requests to add additional reporting requirements, caps on enrollment, funding limits and other harmful changes to Utah Medicaid that undermine the expansion we voted for.
• How you can help STOP these harmful changes to Medicaid, and how your input during the forthcoming public comment period makes a difference.

Check out this recent slide show presentation on Utah’s Partial Expansion to learn more ! Utah's Partial Medicaid Expansion presentation

All Utahns deserve access to affordable coverage without barriers, cuts or caps.

Voices for Utah Children’s Response to CMS Approval of Utah’s Partial Medicaid Expansion

Voices for Utah Children is dismayed by the Centers for Medicare & Medicaid (CMS)’s decision today. While we are encouraged that some Utahns will be able to access needed care, too many Utahns will still be left without health coverage.  

In November of last year, Utah voters passed a plan to close the coverage gap and fully expand Medicaid up to 138% of the federal poverty level, bringing federal tax dollars home to Utah. However, during the 2019 Legislative Session, the Utah Legislature rejected the will of voters and rolled back that plan, including the federal funds that came with it, despite outcries from the public, providers, patients, community leaders and many of its own legislators.

Today CMS chose to approve the Legislature’s more expensive partial Medicaid expansion plan -- a plan that will cost Utah taxpayers more, cover fewer people, impose harmful barriers to care and caps on enrollment for low-income Utahns. This plan creates a dangerous precedent for our Medicaid program and gambles with Utah taxpayers’ hard-earned dollars.

Of particular concern in this waiver:

• It doesn’t add up. The waiver forces Utah to spend more of its own money to provide health coverage to fewer people. Utah will only receive $2.30 in federal funds for every state dollar spent on Medicaid instead of $9.30 in federal funds for every state dollar spent under full Medicaid expansion.

• It’s dangerous. Medicaid is designed to help in times of crisis, allowing states to respond to public health emergencies, natural disasters, and to provide support during economic downturns. Limiting the number of people who can enroll in the Medicaid program could leave many vulnerable Utahns shut out from health coverage when they need it most. 

• It doesn’t work. Research shows that work reporting requirements do nothing to help people find work, but instead create unnecessary red-tape and program complexities that result in hard-working, qualified Utahns losing their health coverage.

CMS’ approval of this partial expansion waiver will leave many unable to access affordable coverage and creates more health care obstacles for both parents and children. When parents’ coverage is in jeopardy, kids’ coverage is also at risk. While Voices for Utah Children is encouraged that some Utahns will get coverage starting on April 1, this plan undermines voter-approved full Medicaid expansion. Utahns deserve better; all Utahns deserve access to affordable health coverage without caps, unnecessary red-tape, and stumbling blocks.

For more information please reach out to Jessie Mandle, the Senior Health Policy Analyst at .

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This past Legislative Session, we saw many exciting bills aimed at helping kids grow up in safer and healthier environments. Not all of these bills passed, but they helped bring attention to important social determinants affecting kids’ health outcomes. No matter where a child lives, ALL Utah kids should have the chance to be healthy and succeed.

Getting Kids Outside

Several bills promoted kids’ access to Utah’s parks and outdoors, especially low-income kids and kids of color who traditionally have not had the same access to outdoors recreation. HCR 4 was a bipartisan resolution declaring Utah's Every Kid Outdoors Initiative. It declared that “it is critical for the well-being and development of Utah's children that we promote a healthy, active childhood filled with outdoor experiences for Utah's children.”

SB 222 created the Utah Children's Outdoor Recreation and Education Grant Program, which helps underprivileged or underserved kids have access to outdoor recreational opportunities and education, and encourages kids to engage in hand-on and nature-based learning and play.

 Access to Safe Drinking Water for All Kids

Making sure kids have safe drinking water at school is critical to kids’ health. Staying hydrated should not make our kids sick- or impede their development. HB 360 would have made sure schools and childcare regularly tested their water for safe lead levels, while also providing mitigation funds. As Dr. Claudia Fruin said ‘"Utah has been extremely behind the times in lead awareness and testing initiatives." HB did not pass, but we will continue to elevate this important issue.

Safe Routes to School

Helping more kids walk, bike or roll to school safely is important for kids’ physical, mental and emotional well-being. It keeps our kids active and decreases traffic around schools too.  HB 208 helped to ensure the sustainability of Utah’s Safe Routes to Schools Program.

Addressing the Social Determinants of Health in Early Childhood

What if efforts to help our youngest children included connecting more kids with heathy foods, safe and affordable housing, and accessible transportation? SB 83 would have done just that, drawing on existing community strengths to help improve health outcomes for our youngest Utahns. Unfortunately, this bill did not pass, but it sparked important conversations about innovative and collaborative ways to help Utah families.

This is only a handful of the bills that addressed the social determinants during the 2019 Legislative Session. We also saw some important steps for families’ access to healthy food. Meanwhile, clean air and affordable housing were also hot topics during the Session with significant impacts for children’s health and well-being.

Even though the 2019 Session is over, we will keep working on these issues all year long and look forward to joining with our partners around the state. Utah kids in every zip code need to be able to grow, learn and play in heathy communities.

This Legislative Session, we have heard a lot of thoughtful, important discussion around children’s access to health coverage and care, including needed mental health care. Health insurance helps children connect with affordable care, yet thousands of Utah children are not enrolling in coverage. Utah has the highest rate of kids currently eligible for health insurance, but not enrolled.

Following the Session, Voices for Utah Children will be releasing an in-depth “State of Children’s Care” report that reviews kids’ coverage and care across the state. Here’s a preview look at some reasons why Utah kids are still uninsured…

• Uninsured Parents= kids more likely to be uninsured: Thousands of parents have been left without have health insurance for too long. On April 1^st, parents with incomes between 60-100% of the federal poverty level will be able to enroll in Medicaid coverage. After the passage of Proposition 3 and then Senate Bill 96, there is a lot of confusion among parents around what affordable health care options are still available and the new requirements to getting care. It’s important that up-to-date information is provided to families, so that eligible parents can begin enrolling on April 1^st. Research shows that covering parents helps kids.  
• Keeping kids covered after they enroll: Once kids get enrolled, we need to help them stay covered. Kids can lose coverage because of administrative error, a small change in parents’ income or an employer’s failure to return requested information on behalf of the parent.
• Misinformation and lack of outreach: Many families are confused about what types of affordable options are available to them. Unfortunately, statewide there is a significant lack of outreach funding to help families learn about options and dispel confusion.
• Fear: The federal administration has contributed to a climate of fear that is causing many immigrant families to not enroll, or dis-enroll, their children from Medicaid or CHIP, for fear of reprisal. The majority of children with immigrant parents are eligible for coverage but are not enrolling. We need to counter this climate of fear, create a welcoming environment for new Americans and fight the misinformation of using public benefits.
• Coverage disparities: Utah has one of the highest rates of uninsured Latino/Hispanic children. Alongside fighting the climate of fear for immigrant families, we must also continue to outreach to communities and support families who may not enroll alone.

Unfortunately, as we reported last year, the rate of uninsured Utah children is trending in the wrong direction. For the first time in almost ten years, we saw a troubling rise in the number of uninsured children in our state. Voices for Utah Children is currently working to increase coverage and care for all children with our 100% Kids Coverage Campaign. Let’s work together to help all Utah kids get the coverage and care they need to be healthy and thrive.

Recently Senate Bill 96 was signed into law by Governor Herbert. Here’s our recap of what’s in SB 96 and the next steps for Utah kids and families’ coverage

Where do we go from here?

The Governor and Legislature have said they are committed to an enrollment date on April 1^st, which was also included in Proposition 3. Individuals and parents up to 100% federal poverty level (FPL) will have an important opportunity to enroll beginning on April 1^st. We will work to make sure those newly eligible know that they can get coverage. Thousands of Utahns are counting on getting the care they need as soon as possible.

But as we work toward enrolling those newly eligible now, we will not rest until all Utahns get coverage and care without barriers, red-tape, without risk of losing coverage or benefits.

To that end, we will be opposing Utah’s SB 96 waiver applications to the federal government. It is now up to the federal government to approve Utah’s proposed harmful work reporting requirements, caps and coverage restrictions included in SB 96, which will be imposed on newly eligibile individuals and parents.

It is critical that we make sure the federal government hears Utah’s opposition to these harmful waivers. Utahns voted for full Medicaid expansion without caps or lock-outs, added requirements or red-tape. (For more detail on what’s in SB 96, keep reading!)

A Closer Look at How SB 96 Differs from Proposition 3

“Partial expansion” instead of full expansion:

SB 96 rolls back voter-approved full Medicaid expansion. Instead of expanding Medicaid coverage to those up to 138% of the FPL, SB 96 only expands to those up to 100% FPL. Currently, no state has been allowed to do a so-called partial expansion. If approved, partial expansions have serious consequences for individuals and states, as this Kaiser Family Foundation brief explains.  

Enrollment caps and work reporting requirements:

SB 96 imposes added barriers, caps and requirements on Medicaid coverage, if approved by the federal government. Newly eligible parents and individuals will be subject to work reporting requirements. In states that have passed work reporting requirements already, there is no evidence that they’ve done anything to incentivize work. On the contrary, studies from states that have implemented a clean expansion saw that Medicaid coverage made it easier for people to find work, maintain a job and increase their earning potential. SB 96 also includes an enrollment cap and potential lock-out periods for certain individuals, which could leave some with long periods of uninsurance.

Higher costs and higher risks:

SB 96 will immediately cost more than Proposition 3, gambling on federal approval for waivers that will increase Utah’s future financial risks. SB 96 proposes to use a funding mechanism called a Medicaid per capita cap. A per capita cap changes Medicaid financing from being a shared state-federal partnership, to a fixed amount. If states spend more than their capped amount, it could lead to potential benefit reductions or narrowed eligibility requirements. If Utah is allowed to move forward with per capita caps, this could lead to cuts in benefits or fewer people covered in the future.

Waiver requests and federal approval= an opportunity for advocacy and opposing harmful barriers to coverage:

In order to put SB 96’s caps and restrictions into place, Utah must submit waiver proposals to the federal government for approval. We will work to oppose the waivers and prevent federal approval. If the federal government does not approve Utah’s different waiver requests, then full Medicaid expansion should go into effect in July 2020, as stipulated in SB 96.

Also included in SB 96’s waiver proposals are measures that could help adults experiencing homelessness access housing and continuous care. While we believe the broader provisions of SB 96 are harmful, we applaud the Legislature and Governor for these efforts to leverage Medicaid funding in innovative ways.

We hope that going forward we can continue to work toward effective solutions to help vulnerable Utahns get care, without adding barriers, cuts or restrictions to coverage.

Q: Is there enough money for Utah to expand Medicaid? I keep hearing that the ballot initiative didn’t provide enough money to cover all the costs. Isn’t that why voters chose to increase the sales tax?

A: All fiscal estimates show that Utah has enough money to implement expansion for the first few years, if not longer. A lot of the fiscal impact statements beyond the first years include predictions, different interpretations, and what-if scenarios about the new law.

Bottom line: Utah has the money to implement expansion now;  it’s already in the process of doing so and we shouldn’t slow down.  The sales tax increase that Utah voters supported will ensure there is enough money in the state budget for Utahns to enroll in Medicaid. State agencies are working diligently to implement the law on April 1, as Utah voters approved it. Utah families cannot afford to derail those efforts with costly and burdensome proposals that do nothing more than take our eye off the ball and delay meeting the needs of those who have no other way to afford health care coverage. 

Q: But, really? I hear that other states end up spending a lot more than they expected on Medicaid.

A: There have been numerous, peer-reviewed studies looking at the experiences of other states that have expanded Medicaid, including this Brookings Institute report: Do states regret expanding Medicaid? [The short answer is no]

Medicaid expansion is an economic win for states because of the federal dollars that will be returned. But also because of the many budget offsets that come with Medicaid expansion. States that have expanded Medicaid have consistently found that expansion is a net saver. However, Utah’s current fiscal estimates for Proposition 3 do not appear to include all of the anticipated cost savings and offsets we’ve seen in other states.

Bottom line: The national evidence and data show that the cost to expand for states is minimal, while the overall economic and public health gains are high. Any effort to change Utah’s plan is just a delay tactic that will cost more money and more time and prevent people from getting the health care they need and deserve.  Utah must keep moving forward now. 

Q: So, could the Legislature pass a different Medicaid expansion plan, through a waiver? What does this mean?

A: The proposals legislators are considering would require additional federal approval, through a federal waiver. (Proposition 3 does not require a waiver.) In theory, these plans could cover everyone in the coverage gap. The hitch is that the federal government has to approve such a plan, and there is no public indication or evidence that they would do so, or that any such plans would be fiscally prudent for Utah to implement. What’s more, the Legislature’s plan would require public comment periods, and will be subject to legal challenges, further delaying Utahn’s coverage, not to mention increasing its costs.

In addition, many of the Legislature’s proposed changes to Proposition 3 would include other provisions that put up additional barriers to health care enrollment and amount to radical restructuring of the Medicaid program here in Utah and nationally. These changes make it harder for Utahns to get care and are likely to be challenged in courts, piling on more unnecessary costs and delays.

Bottom line: If the Legislature passes a different Medicaid expansion plan, it will mean more barriers to coverage, increased  administrative costs, and lengthy- if not indefinite- delays. Utah already has a smart, fiscally sound, plan to give families across the state access to the health coverage they need. The state agencies will continue to work to implement that plan as voters intended so enrollment can begin April 1.  Let’s focus on getting people the health care they need and deserve instead of increasing bureaucracy, red tape  and risks that help no one.

Utah Decided: Implement Full Medicaid Expansion without Delay

On November 6, 2018, Utah voters took an historic step, voting to expand Medicaid to adults and families across Utah through Proposition 3. We call upon our Legislature and Governor Herbert to ensure that full Medicaid expansion is implemented by the April 1^st deadline, without any delays or restrictions to care. Proposition 3 will help thousands of Utahns access affordable health insurance and was carefully crafted by healthcare and policy experts to ensure it would deliver on its promises. As Utah voters, healthcare consumers, providers and stakeholders, we stand by the following principles as full Medicaid expansion moves forward in our state.

Utah Decided: Full Medicaid Expansion is Fiscally Responsible

Utah voters approved a small sales tax on non-food items to fund Medicaid expansion. Numerous reports and analyses confirm that this tax increase provides enough funding to implement Medicaid expansion immediately and in a fiscally responsible manner. By expanding Medicaid, Utah will bring home federal dollars that have been set aside for our state. In addition, expanding Medicaid will create new jobs and grow the Utah economy. The hypothetical concerns raised about increasing long-term state costs will need to be monitored as the full economic picture becomes clear; however, these can be addressed and resolved in the future without delaying implementation or fundamentally changing the law.

Utah Decided: Full Medicaid Expansion Promotes Work

Medicaid expansion will help thousands of hard-working, low-wage Utahns get the health coverage they need to improve their lives. People cannot work if they are not healthy. Once the full Medicaid expansion goes into effect, we will have a more seamless public health insurance system that no longer disincentives work by creating an eligibility cliff for individuals and parents.  We support helping all Utahns find stable and productive work.  Medicaid work requirements will increase government bureaucracy and add to the cost of administering the Medicaid program, but, as has been shown in states where work requirements have already been put into place, will do nothing to help unemployed Utahns find work. 

Utah Decided: Full Medicaid Expansion Drives Healthcare Innovation

Medicaid expansion will allow Utah to reduce healthcare costs through improved access to primary and preventive care for all and strengthen our behavioral and physical healthcare systems by reducing uncompensated care. Many states are already delivering better-coordinated behavioral health and primary care services as a result of expansion. Utah has a strong history of healthcare innovation and, with expansion, Utah can continue to develop more efficient ways to provide services, find collaborative solutions for our state’s opioid crisis, improve the quality of care provided, and find better ways to address social determinants of health. Full Medicaid expansion will facilitate improvements to our healthcare sector that support growth and innovation.

Utah Decided: Full Medicaid Expansion Supports Strong Families

Medicaid coverage improves access to needed care for parents and children. When parents have health insurance, children are more likely to also be insured. Health insurance coverage strengthens families’ financial security and helps families avoid medical debt. Families with access to affordable health coverage are more likely to get the care they need to reach their full potential and thrive, and parents have the peace of mind they need to provide for their family.

We, the undersigned organizations, respectfully ask that our leaders implement Proposition 3 as it was written, making only essential technical changes. Voters did not choose to add restrictions or caps that will only delay implementation. For the health and well-being of all Utah residents, we must fully expand Medicaid on April 1^st so Utahns can get the care they need to work, take care of their families and succeed. 

Sincerely,