Policy efforts to bring meaningful change to Utah's faltering health-care system will take time, but as the Utah Legislature lays the groundwork for comprehensive health reform in the upcoming session, improving children's health coverage should be its highest priority.
Last year, both the Legislature and the governor made a commitment to reform health care and to provide relief to the state's uninsured. Given the current economic crisis, it may be tempting to renege on that promise and leave the state's 90,000 uninsured children in the lurch. But that would be a grave mistake.
Covering kids during hard times is the right thing to do for our struggling families and for our economy. Programs like CHIP and Medicaid garner much-needed federal money for the state; cutting rather than expanding these essential programs is a lose-lose for kids and Utah's financial health. For every dollar the state spends on CHIP, it receives $4 from the federal government, effectively discounting the cost of insuring kids through CHIP by 80 percent. Moreover, the federal funds that CHIP and Medicaid bring into the state generate thousands of jobs and boost the local economy.
This generous federal subsidy is just one reason why every major successful state health-reform effort has built on the foundation of insuring all kids. The other reasons are just as compelling: We know that children are inexpensive to cover when compared to adults, states have a framework in place to achieve this goal, and polls show that Americans overwhelmingly support such a policy. Indeed, there is broad consensus among Utahns that insuring all kids should be addressed by our elected officials.
Utah is in an ideal position to lead on this issue. Research has shown that Utah outperforms almost every other state in delivering high quality health care at a low cost. Unlike other states, Utah has the resources and infrastructure available now to extend basic coverage to our uninsured kids through existing programs, innovative approaches and minimal new investment.
How might we achieve this goal? A key first step is to improve enrollment among children already eligible for CHIP and Medicaid (those below 200 percent of the federal poverty level). Some 77 percent of those currently eligible for CHIP are not enrolled.
A second important step is to expand CHIP eligibility to children with family incomes between 200 and 250 percent of the federal poverty level ($42,400-$53,000 for a family of four). Roughly one quarter of uninsured children in Utah fall into this income category — a fact which underscores the need for affordable options for cash-strapped families.
Research has clearly shown that expanding CHIP to moderate-income families has the added benefit of driving enrollment among the lowest-income children, thus improving coverage among those who have been traditionally hard to reach.
But expanding CHIP is only part of the solution. Helping low-income families access and keep job-based coverage must be an integral part of any coverage expansion strategy. Programs like Utah's Premium Partnership (UPP) can provide the added financial boost that working families need to access this important source of coverage. Increasing the UPP subsidy available to low-income working parents to reflect affordability would help families obtain and keep job-based and privately purchased insurance.
No child in Utah should have to suffer because we lack the political will or courage to tackle this important issue. By expanding access to public and private sources of health insurance, we can improve long-term health outcomes, ultimately lower costs and allow our children the chance to become thriving, productive members of our communities.
Korey Capozza is a senior health policy analyst with Voices for Utah Children.