Utah's rise in the percentage of uninsured children and adults has occurred despite Utah's robust economy and low unemployment, conditions that usually lead to a drop in the percentage of uninsured, says Dr. Joseph Jarvis, chairman of the Board of Trustees of the Utah Health Policy Project.

"That points out that the model of financing health care in the 21st century is failing to deliver the goods," he said.

However, Michael Hales, director of Medicaid for Utah, credits the strong economy with a continued decline in the number of Utahns who rely on publicly funded health insurance.

The average number of people on Medicaid fell by about 16,500 from last March to 162,217 this March, he said, and most of the people leaving those roles are families.

"We really are seeing a lot of families impacted by the positive economy," Hales said.

But there are also some encouraging signs, advocates say. Crompton points to the $4 million allocated by the 2007 Utah Legislature that added 12,000 children to CHIP and Gov. Jon Huntsman Jr.'s declaration earlier this year that insuring Utah's children is a top priority.

Since CHIP enrollment reopened in July, more than 5,300 children have been added says Nate Checketts, Utah's CHIP director.

At the start of this month, there were some 23,692 children on the program. That's still down from the 35,290 who were enrolled Aug. 1 of last year, before enrollment closed.

"On an average we lose about 1,000 children per month when we're not accepting new applications," he said.

On a national level, Sen. Orrin Hatch, R-Utah, has been a key supporter of a Senate bill to reauthorize CHIP nationally and boost its funding by $35 billion over five years.

President Bush has threatened to veto the reauthorization, and Sen. Bob Bennett, R-Utah, says he looks forward the debate that will follow the veto.

"I'm in favor of reauthorization, I'm just not in favor of this reauthorization," said Bennett, who voted against it.

Bennett told the Deseret Morning News editorial board Tuesday that he's concerned about the scope of the reauthorization. He'd like to see something closer to the current funding level, and he wants to see all waivers that cover adults eliminated, along with provisions that could move children from private to public coverage.

There are also efforts at comprehensive reform. Hilman points to what she characterizes as the promise of "major, major" systemic health reform in Utah in the months ahead.

Since the spring, a group of about three dozen major players — key legislators, business leaders, health plans and the United Way — have been meeting as a "health care working group" to tackle a health system that is "broken and unsustainable," according to the group's co-chairwoman, Natalie Gochnour, who is also spokesperson for the Salt Lake Chamber of Commerce.