Health

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!

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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

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Children’s Budget Report Finds Utah Is Spending More On Children Than Ever Before, But Education Funding Effort Is At A Record Low

Salt Lake City, December 9, 2021 - Voices for Utah Children, the state’s leading children’s policy advocacy organization, released its biennial Children's Budget Report.  The report, published every other year, measures how much (before and after inflation) the state invests every year in Utah’s children by dividing all state programs concerning children (which add up to about half of the overall state budget) into seven categories, without regard to their location within the structure of state government. The seven categories are as follows, in descending order by dollar value (adding state and federal funds together):

breakdown p1state pie

breakdown p2fed pie

Public investment in children should be understood as a central component of Utah’s economic development strategy.  Examining how much Utah invests in children can help the state evaluate whether it is maximizing the potential of our future workforce through our investment in human capital. 

This is especially important given the rapid demographic changes taking place in our state. The 2020 Census found that 30% of Utahns under 18 are members of a racial or ethnic minority (almost one-third of our future workforce), compared to just 24% in 2010. The investments we make today in reducing racial and ethnic gaps among Utah’s children will enable the state to thrive and prosper for generations to come

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Report highlights are as follows
highlight arrows

good ok bad

Good News: Utah is investing more in the next generation now than ever before, both overall and on a per-child basis

spending per kid

Not-so-good News: The non-K-12 Education portion of the Children’s Budget peaked on a per-child basis in FY 2016 and has fallen since then by 2%

non educ spend per kid

Bad News: Utah’s education funding effort continues to fall to record low levels

 educ fund hist

Additional Trends: Changes in Funding by Source 

overall graph

Trends in Education Funding: UT beat ID for 49th place, still far behind US overall 

us ut funding

UTIDGap

 MEDIA COVERAGE OF THE CHILDREN'S BUDGET REPORT:

Facebook Live Event presenting the 2021 Children's Budget Report, major findings and summaries of all the categories of funding that impact children in Utah.  https://fb.watch/9O05ECPAHi/

 KSL: https://www.ksl.com/article/50308739/utah-children-drowning-in-unmet-needs-according-to-new-budget-report?utm_source=Salt+Lake+Tribune&utm_campaign=93649b5bb5-rundown_12_10_2021&utm_medium=email&utm_term=0_dc2415ff28-93649b5bb5-45560674

KRCL: https://krcl.org/blog/radioactive-110821/ 

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BROAD COALITION CALLS FOR  INVESTMENT IN UTAH’S FUTURE,  NOT TAX CUTS, DOCUMENTS $5.2 BILLION IN URGENT UNMET NEEDS

Salt Lake City – On Monday, November 8, 2021 on the steps of the Utah Capitol, a broad and diverse coalition of advocates for the poor, for disabled Utahns, for education, health care, clean air, and a variety of other popular Utah priorities held a press conference calling on the Utah Legislature to avoid cutting taxes until it has developed a comprehensive plan to address Utahns’ top concerns by investing in Utah’s future.

Following nearly two years of the COVID-19 pandemic, Utah is fortunate to have achieved a more rapid economic recovery than nearly every other state. Utah has also received billions in federal assistance that have padded state revenues – but only temporarily. It is expected that the Governor and Legislature will have at least $2.5 billion in new revenues to appropriate in the 2022 General Session of the Utah Legislature. 

This has led some to say that Utah is “swimming in money” and should cut the state income tax rate from 4.95 to 4.5%, a tax break of $600 million (that mostly benefits upper income families rather than Utahns in need). This tax break would be over and above the roughly $3.5 billion that the Legislature has already cut from annual revenues in recent decades (seehttps://le.utah.gov/interim/2021/pdf/00003683.pdf slide #3).

In response, today the Invest in Utah’s Future coalition presented a list of urgent unmet needs amounting to $5.2 billion, more than double the amount of the expected new revenues.

The advocates also pointed out that, according to recent reports 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. “We understand that tax cuts are popular, but we’ve reached the point where we must ask ourselves: 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 the recent public opinion survey by the Deseret News and Hinckley Institute that found that only 27% 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, adding up to a total of $5.2 billion:

 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. (Source: UEA)

 

Utah Education Association Director of Policy and Research Jay Blain

   
 K-12: Paraeducators   $312 million  

Expand paraeducators to all Utah elementary classrooms. (Source: UEA)

 

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.   (Source: UEA)

 K-12: school psychologists, social workers and special ed teachers  $285 million  

Increase student access to school psychologists, social workers and special ed teachers.  (Source: UEA) 

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
 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  $84.4 million  

The Utah Department of Health annual report “Nursing Services in Utah Public Schools 2020-21” found that it would cost $84.4m to hire an additional 844 nurses so as to have one nurse in every public school building. There are currently only 224 nurse FTEs in Utah’s public schools, a ratio of 1 nurse for every 2,617 students. One nurse in every building would improve that ratio to 1:623, which would still be worse than the national average. 

Sources: www.utahschoolnurses.org/, www.nasn.org, www.sltrib.com/opinion/commentary/2021/10/01/diane-nicoll-utah-schools/  
 

Dr. Jennifer Brinton, MD, President, American Academy of Pediatrics – Utah  and Dr. William Cosgrove, Past-President -

 

K-12: 

Homeless Students

 $105.8 million  

HUD vouchers do not cover students and their families who are homeless under McKinney Vento Dept. of Education definition. For the 2019-2020 school year, Utah had a little over 13,500 K-12 homeless students. Some of them are duplicates as students move from one district to another. Also the same household has multiple children.  If we assume we have: 

  • 9,000 households with homeless students 
  • fair market rent at $1,400  
  • families paying $420 for their rent (30% AMI)
  • voucher will pay $980 monthly
  • total annual allocation is $105,840,000

Source: Utah Housing Coalition

 

Utah Housing Coalition Advocacy & Outreach Coordinator Francisca Blanc –  

 Full Day Kindergarten  

$52.5 million

 Voices for Utah Children estimates that it will cost $52.5 million to make full-day Kindergarten available to all Utah families who would choose to opt in to it.  Voices for Utah Children Sr. Policy Analyst Anna Thomas  and Pastor Brigette Weier, Our Saviour’s Lutheran Church  
 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 this past year’s 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. (Source: Utah Afterschool Network) Utah Afterschool Network Director Ben Trentelman –  
 Health Insurance: Children  $5 million  It would cost Utah about $5 million to pay for SB158 to remove barriers to health insurance coverage so that all Utah kids can access health insurance, including 12-month continuous eligibility. 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  Voices for Utah Children Deputy Director Jessie Mandle  
 

Health Insurance:

New parents
 $5 million  Extending Post-Partum Medicaid Coverage for new parents up to one year (now just 60 days) Source: Voices for Utah Children
 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.” (page 51)

Stakeholders identify the highest priority items as: housing and workforce capacity.  There is a need to expand student enrollment slots in universities for MSWs (Masters in Social Work), MFTs (Marriage & Family Therapists) and MHCs (Mental Health Counselors), and to provide scholarships at these institutions to attract students. 
 
 Disability Services  $30 million  

The DSPD disability services waiting list has doubled in the last decade from 1,953 people with disabilities in 2010 to 3,911 in 2020.

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 $30 million to eliminate the waiting list entirely. 
 Legislative Coalition for People with Disabilities – Jan Ferre
 

Rural Utah Economic Development

 Uncertain  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.   Community Action Partnership of Utah - Stefanie Jones and Clint Cottam –  
 Transportation Access  $300 million  

Increase access to employment and educational opportunities for more people, especially lower-income communities. Provide additional transit connections, including extended evening and weekend service. Establish more ‘active transportation‘ (bike and pedestrian) connections to increase equity of access. 

Source: Wasatch Front Regional Council
 
 Left Behind Workers and Families   $154 million  

Last year’s report “Left Out: Adding Up the Cost of Excluding

Undocumented Utahns from State and Federal COVID-19 Relief” showed how undocumented Utahns and their families (comprising 39,000 households with over 100,000 individuals) work hard and pay taxes but were excluded from $154 million of federal COVID and unemployment relief.
 Comunidades Unidas – Brianna Puga –  
 Sexual and Domestic Violence  $85 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. 

The Utah Domestic Violence Coalition 2017 Needs Assessment identified insufficient funding for shelters, affordable housing, child care, legal representation, and mental health and substance abuse treatment services as major obstacles to protecting women from domestic violence. 

In the 2021 Utah Legislative Session, fourteen private non-profit domestic violence service providers submitted an appropriations request of $3.4 million in ongoing state funds. However, only $1.7 million was funded through federal TANF funds. No ongoing state funds were approved. Unfortunately, only two domestic violence service providers were able to accept and utilize the TANF funds. The remaining twelve domestic violence service providers were unable to accept those funds because TANF eligibility requirements conflict with Violence Against Women Act (VAWA) confidentiality provisions. 

The actual cost to meet the needs of Utahns experiencing sexual and domestic violence is much higher than is reflected in the 2021 appropriations request and has been estimated to total $85 million. (Source: Utah Domestic Violence Coalition, Utah Coalition Against Sexual Assault, Restoring Ancestral Winds)

 

Gabriella Archuleta, Director of Public Policy, YWCA Utah    

and

Yolanda Francisco-Nez, Executive Director of Restoring Ancestral Winds  
 Housing  $415 million

Funding to build affordable housing state-wide for people earning less than 50% AMI. In Salt Lake County alone, the current need is $1 billion.  Affordable housing units fall 41,266 units short of meeting the need for the 64,797 households earning less than $24,600. Among extremely low-income renter households, 71% pay more than 50% of their income for housing, which is considered a severe housing burden.

For more information on the current and ongoing needs visit https://endutahhomelessness.org/wp-content/uploads/2021/06/HousingNow-Deck-12.pdf
  

Catholic Diocese of Salt Lake - Jean Hill -

 Homeless Services  $55 million   Case manager positions have been underfunded for the past several years and most do not make a living wage. The homeless resource centers in Salt Lake County also maintain a perpetual gap in state funding of at least $3 million per year. In 2019, homeless service providers across the state sought $41 million in funding for ongoing programs, including case management.  At that time, the state provided $12 million. The following year, the state provided $9 million.  Covering even the basic needs of providers would be a huge step forward in our efforts to reduce homelessness across the state.  
 Housing for Seniors   

$30 million/

year for 10 years
 

If we don’t fund preservation of affordable housing for seniors we will lose valuable units. A very general estimate would be $50,000 per unit for perhaps 5,000 units.  This equates to $250 million in rehab costs. 

What is more realistic is subsidizing 5,000 at say $500 per month or $30 million per year which would allow these projects to Borrow the money for rehab. Over 10 years the total is $300 million but the state would pay this over 10 years. The $250 million up front to rehab the units would likely keep them going for 10 years, then more rehab would be required. 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  
 Air Quality  $100 million  In 2018 Gov. Gary Herbert proposed $100 million for clean air initiatives but the Legislature did not fully fund this goal. 

The Wasatch Front ranks as the 11th worst air quality in the nation for ozone and 7th worst for short-term particle pollution.

Investments should align with the principles in Kem C. Gardner Policy Institute Road Map, and have fallen short in previous years. 
 
 Air Quality in Schools  

$35 million

 Funding for air purifiers in every classroom in Utah, which would reduce the risks both from COVID and from Utah’s air pollution and could be 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  $60 million  Funding for UTA to eliminate fares entirely on all UTA conveyances as has been done already in dozens of cities to varying degrees, including in the SLC Free Fare Zone. (Source: Steve Erickson fiscal estimate, https://freepublictransport.info/city/ )  Steve Erickson -  
 Hunger  Uncertain  It is clear that the state needs to do more in providing funding and other resources to help support local community food pantries. Earlier this year, Utahns Against Hunger conducted a community food pantry survey and found that in 2020, a quarter of pantry respondents had a funding gap, with 15% of respondents having a gap of $10,000 or more.  Utahns Against Hunger – Gina Cornia –  and Alex Cragun  
 Utah EITC  

$100 million

 Utah should become the 31st state to offer a 20% state match to this highly popular federal tax break. This refundable tax cut targeted to low- and moderate-income working families has been proven to reduce poverty by drawing lower-skilled persons into the workforce, moving them toward independence and self-sufficiency. Most of this tax cut goes to the lowest income fifth of Utahns, those earning under $28,000, and the rest goes to the second fifth of the income scale, those earning under $50,000.   Voices for Utah Children – Matthew Weinstein –  
 Eliminate the sales tax on unprepared food  $130 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.

 Rev Libby Hunter, Cathedral Church of St. Mark, speaking on behalf of the Coalition of Religious Communities (Bill Tibbitts – )   
 About those water project boondoggles…    Federal rules permit the use of ARPA funds for water infrastructure projects, but Utah would save billions of dollars and millions of gallons by investing in conservation first to reduce usage in one of the most water-wasteful states in the nation. Those ARPA dollars would be better used addressing the urgent unmet human needs of our fellow Utahns.   Utah Rivers Council – Zach Frankel –  and Lindsey Hutchison  
 Racial Equity, Diversity, and Inclusion    

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 new Utah Compact on Racial Equity, Diversity, and Inclusion must be more than just words on a page.

 https://slchamber.com/public-policy/utah-compact/ 
 Angel Castillo, Ogden NAACP  

 TOTAL

$5.177 billion – more than double the amount of “surplus” revenue that the Legislature expects to have   

  3.4b tax cut USTC

3.4b tax cut text

 Invest press conf 11 8 21

Live recording of the Invest in Utah's Future press conference 11/8/21: https://fb.watch/99bpgYEAqp/ 

Printable version of this document is here

Media coverage is posted at KSL and Deseret News and Fox-13.  

ONE PAGERS ABOUT THE VARIOUS UNMET NEEDS: 

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