The number of uninsured children in Utah grew by 22% in two years — and the increase in the rate of children without health insurance was the second-highest of any state, according to a new report from Georgetown University.

In total, 72,000 Utah children were not covered by health insurance in 2018, according to researchers from Georgetown’s Center for Children and Families. That’s 7.4% of the state’s children — the eighth worst rate in the country and well above the national average of 5.2%, the study found.

Two years earlier, 6% of Utah children were uninsured; only Tennessee saw a faster increase, researchers reported.

“This trend is extremely troubling,” Jessie Mandle, senior policy analyst with Voices for Utah Children, said in news statement. “We want every Utah child to have health coverage. We encourage those who can to enroll in Medicaid and for the state to move toward full expansion and elimination of any barriers to coverage. It’s critical we adopt policies that promote continuous coverage so all kids can get the care they need to thrive.”

Children in states that had not expanded Medicaid were nearly twice as likely to be uninsured as children in states that had, researchers found. In 2018, Utah voters approved expanding Medicaid to everyone earning up to 138% of the federal poverty level — the lowest income limit required to receive the 90% federal funding of Medicaid guaranteed under the Affordable Care Act.

But the state Legislature overturned the voter-passed initiative and passed in its place a partial expansion, covering only those at or below the federal poverty level. Utah legislators had hoped for enhanced federal funding with only the partial expansion, but they received word this summer that the Trump administration denied their request, which will trigger full Medicaid expansion next year.

“Recent policy changes and the failure to make children’s health a priority have undercut bipartisan initiatives and the Affordable Care Act, which had propelled our nation forward on children’s health coverage,” Joan Alker, executive director of the Center for Children and Families, said in a statement.

However, researchers wrote that losses were “most pronounced” for children from families earning between 138% and 250% of the poverty level — those just above Medicaid limits even in states where expansion has occurred.

Nationwide, the number of children without health insurance grew by 400,000 between 2016 and 2018, with a rate increase from 4.7% to 5.2%, the study found. The losses were most dramatic for white and Latino children, though the worst rates overall were among Native American children, researchers wrote. Black children saw a slight improvement in coverage, they wrote.

Declines in coverage also were significant for children under age 6, researchers wrote.