A report says Utah’s rate of uninsured children went up last year, but advocates say Medicaid expansion will bring it back down

(Al Hartmann | Tribune file photo) Mothers with their children wait in line to get immunization shots at the Junior League CARE Fair in the Horizonte Center in Salt Lake City Friday July 15. It's Utah's largest free health fair in its 24th year in the community. No appointments or insurance is needed. Services range from physical and well child exam to immunizations, vision, hearing and speech screenings and dental exams.

In Utah and around the country, fewer children were insured in 2017 than in 2016, according to a report released Thursday by Georgetown University’s Health Policy Institute.

Researchers wrote that access to health coverage was affected by debates over the Affordable Care Act — including the repeal of the individual mandate and efforts to undermine enrollment — and an “unprecedented” lapse in funding for the Children’s Health Insurance Program, or CHIP.

Policies targeting immigrant communities likely also deterred parents from enrolling their children in federal health-care programs, the report states.

“This constellation of national trends has likely created an ‘unwelcome mat’ effect," the report states, “where families are unaware of their options or deterred from seeking coverage.”

Utah was one of nine states that saw a statistically significant increase in its rate of uninsured children in 2017, according to the report. The rate of uninsured children was 7.3 percent in 2017, up from 6 percent in 2016, the report states, with each of those years showing Utah behind the national average.

But those numbers are disputed, somewhat, by the Utah Department of Health. Spokesman Tom Hudachko said the state’s numbers show the uninsured rate for all Utahns increasing between 2016 and 2017, but it was flat for children.

“It’s certainly a move in the direction that we don’t want to be moving in,” he said. “We would like to, obviously, see more people with access to health-care coverage.”

Hudachko attributed the discrepancy to methodology. The state applies a different age group to the category of “children” than the Georgetown study, he said, and uses different wording in its survey to ask about insurance coverage.

But independent of methodology, he said, there are tens of thousands of children in Utah who lack insurance.

“Whether you go with our numbers or whether you go with [the Georgetown University] numbers, there’s either 60,000 or 70,000 uninsured kids in Utah,” Hudachko said. “And that’s too many.”

Jessie Mandle, a senior health policy analyst with Voices for Utah Children, said it’s unclear whether the state’s trends for uninsured children will continue in 2018. But the rate should improve in 2019, she said, after full Medicaid expansion is implemented in response to the successful passage of Proposition 3.

“I think expansion will be one of the most effective ways to counter this negative trend,” Mandle said.

The Georgetown University report notes that three-quarters of the children who lost health care insurance between 2016 and 2017 live in states that have not expanded Medicaid, like Utah. And overall, non-expansion states have higher rates of uninsured children than those states where expansion has already occurred.

By voting for Prop 3, voters approved an expansion plan that will combine roughly $90 million in state revenue and $800 million in federal funding to provide health care coverage to 150,000 low-income Utahns with an income at or below 138 percent of the federal poverty level. That expansion will be implemented in April.

And while many uninsured children already qualify for government health-care programs, Mandle said there is a correlation between adults qualifying for expanded Medicaid coverage and their children becoming insured.

"When parents have coverage, the research shows the children come along with them," Mandle said.

Because Medicaid expansion targets low-income adults, Hudachko said it is not yet known how Proposition 3 will affect the state’s rate of uninsured children. But he agreed with Mandle that there is reason to believe more Utah children will gain health-care coverage as more of the state’s adult population becomes eligible for Medicaid.

“It’s an argument that does make sense,” he said.

Mandle said health-care coverage for children is critical, affecting their education and beyond. Inadequate health care could mean a child going without glasses and struggling to read, Mandle said, or facing extended classroom absences — or worse — a condition that is left untreated.

“Coverage is that foundation that kids need to be healthy and thrive throughout life,” she said.