Utah Poverty Advocates Call for Fairer Taxes and Restoration of Public Revenues

Salt Lake City - Today (September 26, 2019) at the Utah State Capitol, a group of two dozen non-profit organizations that provide services to and advocate on behalf of Utah's low- and moderate-income population released a letter to the Tax Restructuring and Equalization Task Force. The letter calls on the Task Force to consider the impact on low-income Utahns as they consider tax changes that could, in the worst case scenario, make Utah's tax structure more regressive and less able to generate the revenues needed to make critically important investments in education, public health, infrastructure, poverty prevention, and other foundations of Utah's future prosperity and success. 

The text of the letter and the list of signatories appears below (and is accessible as a pdf at this link): 

 Open Letter to the Tax Restructuring and Equalization Task Force (TRETF)

Tax Reforms for Low- and Moderate-Income Utahns

September 2019

Dear Senators, Representatives, and Other Members of the TRETF:

We, the undersigned organizations that work with and advocate for low- and moderate-income Utahns, urge you to consider the impact on the most vulnerable Utahns of any tax policy changes that you propose this year.  

We urge you to address the two major challenges facing our tax structure as it impacts lower-income Utahns:

1)     Utah’s current system of taxation is regressive, in the sense that it requires lower-income Utahns to pay a higher share of their incomes to state and local government than it asks of the highest-income Utahns, even though about 100,000 lower-income Utah households are forced into – or deeper into – poverty by their tax burden every year. 

This regressivity could be addressed with tax policy changes including the following: 

1. A Utah Earned Income Tax Credit (EITC) to allow the working poor to keep more of what they earn.
2. Remove the sales tax entirely from food, as 34 other states have done.
3. Remove the state income tax on Social Security benefits for low- and moderate-income seniors; Utah is one of only 13 states that tax these benefits.
4. Restore the income tax rate to 5% or increase it above that level. (Because the majority of all Utah income is earned by the top quintile of taxpayers, and because the Utah income tax more closely matches Utah’s income distribution than any other tax, most of such an income tax rate increase would be paid by the top-earning 20% of Utahns, while most lower-income Utahns are shielded from income tax rate increases.) 
5. Disclose and evaluate the effectiveness of tax expenditures (revenue lost to the taxing system because of tax deductions, exemptions, credits, and exclusions); Utah’s lack of transparency in this area of taxation earned us a C grade from the Volcker Alliance, a leading evaluator of state budgetary practices founded by former Federal Reserve chairman Paul Volcker. 

2)     For decades, Utah’s overall level of taxation relative to the state’s economy has been dropping, as illustrated in the chart below from the Utah State Tax Commission:

The unfortunate result is that we are left with a tax structure that fails to generate sufficient revenues to allow our state and local governmental entities to properly meet their responsibilities and fulfill their appropriate role in a number of critical areas, including the following:

1. Education: Utah ranks last nationally for our per-pupil investment in K-12 education. Particular areas of weakness include:

• •  · Teacher turnover rates are higher than the national average. One study found the majority of new teachers leave within seven years.
  •  · Pre-K: Utah ranks 36th for our percent of lower-income 3- and 4-year-olds attending pre-school, private or public. We are also 1 of only 7 states not to have statewide public preschool programs. (The state offers only small-scale programs in a limited number of local school districts.) Yet we know from multiple research sources that every dollar invested in high-quality day care and preschools produces at least a $7 return on that investment in future years. 
  •  · Kindergarten: Only a third of Utah kids participate in full-day kindergarten, less than half the national average, because local school districts can’t afford to offer it. Voices for Utah Children estimates that it would cost at least $75 million to offer full-day K to all Utah kids (not including potential capital costs). 
  •  · According to the January 2019 report of the Utah Afterschool Network, the need for after-school programs exceeds the supply many times over, leaving tens of thousands of children completely unsupervised, meaning they are less likely to do their homework and more likely to engage in unsafe activities.

In addition to these input measures, Utah is also lagging behind in terms of several significant educational outcome measures:

• •  · Our high school graduation rates are lower than national averages for nearly every racial and ethnic category, including our two largest, Whites and Latinos.
  •  · Among Millennials (ages 25-34), our percent of college graduates (BA/BS or higher) lags behind national trends overall and among women.

Moreover, Utah is in the midst of a demographic transformation that is enriching our state immeasurably but also resulting in majority-minority gaps at a scale that is unprecedented in our history. For example, in our education system:

• •  · Our gap between White and Latino high school graduation rates is larger than the national gap. 
  •  · Education Week recently reported that Utah ranks in the worst 10 states for our growing educational achievement gap between haves and have-nots.
  •  · We are beginning to see concentrations of minority poverty that threaten to give rise to the type of segregation and socio-economic isolation that are common in other parts of the country but that Utah has largely avoided until now.

B. Infrastructure: Utah’s investment has fallen behind by billions of dollars. This is another area where the Volcker Alliance ranked Utah in the worst nine states for failing to track and disclose to the public the dollar value of deferred infrastructure replacement costs. In addition. Internet infrastructure is lacking in some rural counties, limiting their integration into Utah’s fast-growing economy.

C. Mental Health and Drug Treatment: Utah was recently ranked last in the nation for our inability to meet the mental health needs of our communities, according to a recent report from the Kem C. Gardner Policy Institute. Underfunding of drug treatment and mental health services costs taxpayers more in the long run as prison recidivism rates rise because the needed services are not available. Estimates are that Utah meets only 15% of the need for these vital, life-saving services. 

 D. Affordable housing units fall 41,266 units short of meeting the need for the 64,797 households earning less than $24,600, yet the annual $2.2 million state allocation to the Olene Walker Housing Loan Fund has not changed in over two decades, despite inflation of over 60%. Among extremely low-income renter households, 71% pay more than 50% of their income for housing, which is considered a severe housing burden. This year, the Olene Walker Housing Loan Fund used up most of its annual $14 million budget at its very first meeting of the fiscal year (made up of both state and federal funds). 

E. Health care: Our rates of uninsured children are higher than national averages – and rising – especially among the one-in-six of our children who are Latino. In Utah 35,000 or 5% of White children are uninsured (national rank = 36^th place), compared to 31,000 or 18% of Latino children (rank = 46^th = last place in 2017). 

 F. Disability services: The 2018 annual report from the Utah Department of Human Services’ Division of Services for People with Disabilities reports that the wait list for disability services grew to a record level of 3,000 individuals last year and that the average time on the wait list is 5.7 years. 

 G. Seniors: The official poverty measure undercounts senior poverty because it does not consider the impact of out-of-pocket medical expenses. A 2018 study found that seniors spent $5,503 per person on out-of-pocket medical expenses in 2013, making up 41% of their Social Security income. (For most seniors, Social Security is the majority of their income, and it makes up 90% or more of income for 21% of married couples and about 45% of unmarried seniors.)  

 H. Domestic Violence: Although Utah's overall homicide rate is significantly lower than the national average, domestic-violence-related homicides constitute over 40% of Utah's adult homicides compared to 30% nationally. Several thousand women continue to be turned away annually from crisis shelters because of lack of capacity. Additional state funding would make it possible to substantially increase the capacity of overburdened crisis shelters. We are one of the few states without domestic violence services in every county.

Given the large number of urgent needs that are not being met because of our chronic shortage of public revenues, we are concerned that Utah is missing the opportunity to make critically important upfront investments now that would allow us to reap substantial rewards in the future, and that our most vulnerable neighbors will pay the greatest price as a result.

Thus, we urge you to consider the ways that the state tax structure impacts single parents, disabled adults, low-income children, seniors on fixed incomes, and other vulnerable population groups as you decide on your tax restructuring and equalization proposals.

 Finally, thank you for all the time and effort you are personally investing as volunteer members of this important Task Force, and for all that you do for our state through this and other forms of public service. 

Yours truly,   

New reports that the Trump Administration will not grant Utah waivers for a partial Medicaid expansion only underscore what we know: Utah must move forward with full Medicaid expansion, without delays or barriers.

Too many Utahns have been shut out, unable to access health care, because of partial expansion: Families making just above the poverty level; kids, whose coverage is affected by their parents’ coverage; new moms 60 days postpartum; individuals trying to improve their lives. Let's not gamble with Utahns' health care any more; too many Utahns have been kept in limbo and left out of coverage.

It’s time for Utah to stop paying more to cover fewer people and move forward with the full Medicaid expansion Utahns clearly support and need.

Updates on kids coverage in Utah: Kids are losing Medicaid/CHIP coverage, meanwhile Utah is still paying more to cover fewer people…and more!

Why are Utahns paying more to cover fewer people?

Under Utah’s current partial expansion plan (aka the “bridge plan”), Utah is paying 30% more to cover thousands of fewer kids and families on Medicaid. To date, around 34,000 new individuals have enrolled in Medicaid coverage, although at least 50,000 still remain in the gap, unable to afford coverage on their own and not offered it through their job. Utah has left at least $7 million in federal funds on the table so far-- funds that could be used to help more families get coverage and care. (New update: latest reports state the Trump administration will reject Utah's partial expansion. It's time to stop paying more to cover fewer people.)

Alarming Trend in Kids' Medicaid/CHIP Coverage

Utah kids are dis-enrolling from Medicaid/ CHIP at an alarming rate. At the July Utah Medicaid Advisory Committee meeting we learned that over 2,000 kids lost Medicaid/CHIP coverage last month. Such a steep drop cannot be explained by a strong economy alone. The number of Utah kids leaving CHIP/ Medicaid are among the highest in the nation. Both the Utah Department of Health and Department of Workforce Services have committed to doing additional investigation as to WHY kids are losing coverage. We greatly appreciate that they are taking this issue seriously and are working to find answers.

Utah Medicaid Advisory Committee Once Again Prioritizes 12-Month Continuous Eligibility- Let's Keep Kids Covered!

For the third straight year, the Utah Medicaid Advisory Committee prioritized 12-month continuous eligibility for children on Medicaid as one of their top funding requests to the Governor. 12-month continuous eligibility would allow more kids to get covered- and stay covered. Current Medicaid reporting requirements mean many kids unnecessarily lose coverage, with cascading negative impacts. This policy would protect kids and families. The Utah Medicaid Advisory Committee has continually prioritized this as a cost-effective, best practice to keep kids healthy, consistently voting in favor of the Utah Department of Health adopting this policy.

The Latest on Utah’s Medicaid Waiver

Utahns submitted a record 1,700 comments on Utah’s partial Medicaid expansion. Thanks to all who stood up for voter-approved full Medicaid expansion. Utahns voiced strong opposition to the proposed cuts, caps and barriers to Medicaid coverage which would leave many kids and parents without coverage or care. These comments send a message to state and federal officials and will provide the backbone for any future legal action.

Haven’t submitted a comment yet? There’s still time! Submit a comment here: www.utahchildren.org/comment

Voices for Utah Children opposes the state of Utah’s proposal to make harmful changes to the Medicaid program. As part of Senate Bill 96, which rolled back Proposition 3 full Medicaid Expansion, the Utah Department of Health is required to seek a federal waiver to add restrictions and cuts to Medicaid. The  “Per Capita Cap” waiver is a dangerous proposal that puts the overall financial stability of the Medicaid program at risk by capping funding and creating new barriers for families seeking care.  

This waiver proposal undermines voter-approved full Medicaid expansion; it limits coverage options to a fraction of those who need it; and sets a dangerous precedent for other states looking to deny vulnerable residents affordable coverage options.

It is imperative that Utah instead realize full Medicaid expansion- without caps, cuts or barriers, so Utahns can get the affordable coverage they need to thrive.

The public now has an important opportunity to comment on the waiver proposal. Public comments play a critical role and can make a difference in defeating these proposed harmful changes. Learn more and submit your comments.

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Report: 2019 UTAH STATE OF CHILDREN’S COVERAGE REPORT 100% Kids: Giving All Kids the Opportunity to Thrive

Executive Summary

Health insurance coverage provides children with the foundation they need to be healthy and thrive. When children have health insurance, they have better health outcomes, greater academic success and more economic opportunities later in life.

Utah lags behind the rest of the nation when it comes to covering kids. In Utah, 7% of all children are uninsured, compared to 5% nationally. While Utah has made significant strides over the years connecting more children to coverage, in the last year, Utah’s child uninsured rate has increased. In 2017, Utah was one of only nine states to see its child uninsured rate trend in the wrong direction.

Who are the uninsured children of Utah? They are overwhelmingly low-income. Typically, their parents are uninsured too. The majority are eligible for CHIP or Medicaid insurance, but not enrolled. Some are not eligible for insurance at all because of their citizenship or immigration status. They live across Utah, with a higher percentage of uninsured children living in rural areas. Some children may have never been insured; some may have had insurance and then lost it or had a parent dis-enroll them due to stigma or fear of enrolling in public health insurance programs. They come from all racial and ethnic backgrounds however, a disproportionate percentage of uninsured children in Utah are Latino, the highest in the nation. Some come from families experiencing intergenerational poverty, some are immigrants, refugees or asylum seekers, facing steep obstacles to their health and well-being.

But no matter who they are, they are all Utahns. When 7% of our child population lacks health insurance, we put Utah’s future at risk. Utah is at a unique moment to challenge the negative trends and demand that all children, no matter their background, zip code, citizenship or immigration status, can access affordable health coverage.
The 100% Kids Coverage Campaign is led by a diverse coalition of stakeholders. This multi-year campaign has a goal of ensuring all Utah children will have coverage. Guided by four over-arching policy recommendations, the Campaign proposes to change Utah’s health coverage landscape:

1. Strengthen and protect Medicaid coverage for parents
2. Keep kids covered all year round
3. Support consistent outreach and enrollment support
4. Cover all kids, regardless of background or immigration status

Through targeted policies, political and community engagement, we can ensure that all Utah kids have the health coverage they need to grow, thrive and succeed in life. We believe that it is possible for 100% of Utah children to have access to affordable, consistent health coverage. We invite you to join us and help us reach 100% together.

The full report can be downloaded below. For a free print copy please call Voices at 801-364-1182

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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Utah is not getting the expansion we voted for… Utah Medicaid is facing serious threats

The Legislature’s bill rolling back Proposition 3 includes several harmful changes to Medicaid. The bill proposes to:

• Create additional reporting requirements for enrollees
• Limit the number of people who can enroll in Medicaid
• Make it harder for individuals to access care

These changes would lead to cuts for Utahns’ healthcare and coverage and will put the Utah Medicaid program at risk.

Your Comments Are Needed!

The Utah Department of Health – at the direction of the Governor and Legislature — have released a proposal to make these harmful changes to Utah Medicaid...again.

Comments are the best way to defeat these harmful proposed changes to Utah Medicaid and get us back to the straightforward, full Medicaid expansion you voted for.  Without restrictions or barriers to care. The federal and state government are required to consider all comments; if they don’t, then the proposal can be overturned through legal action. Comments are the reason Kentucky’s Medicaid proposal was stopped in its tracks.

Submit your comments here. Thank you for your continued action!

But wait! Even with these confusing changes, many more people are eligible for Medicaid now because Utah has partially expanded Medicaid. If you or someone you know applied before and were rejected, it is a good time to check again. Find out if you qualify for coverage here!

Learn More:

Work requirements don’t work; in fact, they lead to eligible people losing their Medicaid coverage. Learn more about Arkansas’ failed work requirement policies.

Confused? Need a refresher on Utah's messy path to full Medicaid expansion. Check out this overview from our friends at the Utah Health Policy Project.

How did Proposition 3, a.k.a voter-approved full Medicaid expansion, compare to the Legislature’s partial Medicaid expansion bill, aka SB 96? Learn more.

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 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.

Immigrant Families on Health Coverage

Thanks to Centro de la Family, the Consulate of Mexico in Salt Lake, Holy Cross Ministries, and Utah Health Policy Project, we were able to survey 34 immigrant families about health care, access to health insurance, what having health insurance or not has meant for them.

The immigrant families surveyed range in location and statuses many families live in mixed immigration statuses from undocumented, legal permanent residents, and U.S. citizens.

From all the surveys, one thing was clear: having access to quality health insurance such as CHIP or Medicaid has made a difference for these families in terms of health, overall wellbeing, and financial security.

“It has meant a lot especially because I have a son with disabilities and a lot of doctor’s appointments.”

“[Medicaid/CHIP] is great, it has made us feel like my children are protected.”

“It brings me peace to know that when my children need medical attention or have an emergency, I have place to take them without being overwhelmed by billing”

“My children have health insurance and I feel good with it because whatever happens I can take them to the doctors.”

These quotes were taken directly from mothers who took the survey and were able to take their children to receive the necessary wellness checks throughout the year for their children and felt the safety net that CHIP and Medicaid provided. This safety net has allowed these families to spend less on health care, access the services they need, and not feel overwhelmed by the health care system. Many of them talked about a feeling of “tranquility” from having access to

For the families that were unable to have access to health insurance the amounts they owed ranged from owing $300-$5,000 in medical bills. 6 families reported their sick children got other family members or other classmates sick, 5 said they caused absences in school, and 4 of them also said an adult at home missed days of work and had to stay home.

One mother said, “Having health insurance for my children has been of great importance to me, I have felt happy to have their physical checks done and my children are very healthy.”

Another mother said, “It helped us during the time that my husband was unable to work, and we had low resources, mi children went to the emergency room and were able to get treatment.”

One mother also talked about the benefits of having health insurance meant her family and her were able to understand the benefits that are much greater than spending less on health care: “I learned that having regular physical and dental check ups that are covered by Medicaid you can reduce the risk of developing serious illnesses and that has helped my family and children a lot.“

Overall the theme remained the same, having health insurance such as Medicaid and CHIP provided relief for all the families that were surveyed. Each of them had different concerns but most of their main concerns were the wellbeing of their children and having the means to pay for their wellness checks. While there is still a climate of fear that surrounds immigrant families, they all had an understanding of the importance of health care and health coverage. Thanks to these vital programs, families can move forward, take care of their medical needs, and take care of their families. With our 100% Kids Coverage Campaign we are hoping to improve coverage and care for all families in Utah! If you would like more information about our campaign, please click here or email !

Together we can work towards 100% Kids Covered in Utah!