Rhonda, a welfare mother, is beginning to take baby steps back to the economic independence about which she never used to think.
For almost two years, she and her two children have relied on government grants for the most basic of human needs: food, clothing, a roof overhead and medical care. They have lived at half the poverty level, choosing between essentials like shoes and food like she once chose between two outfits.They don't go to movies or eat out much. It just isn't possible.
Rhonda says she'd like to provide for her children herself and, with a good job, she knows she could.
But as she works with her case manager to achieve her goals, she admits that she's terrified.
Her fear is illness. As discouraged as she has sometimes been by her economic situation, she has drawn comfort from her Medicaid card. At least, she says, she has been able to get help when her children are ill. A serious illness, she knows, could be disastrous.
Her situation may not be as precarious as she thinks, because the Family Support Act brought with it a bridge that guarantees she won't lose Medicaid the minute she stops receiving a welfare grant.
Like most bridges, though, this one does end. Then she must have a job that provides insurance or she'll need to make enough money to buy her own.
Living without health insurance is no joke for thousands of Utahns who either cannot afford it or cannot get it because of pre-existing medical conditions.
Nationwide, in fact, the problem has reached crisis proportions. Pundits debate whether health care is actually a right that should be guaranteed. Hospitals fret about rising costs and the amount of money they don't receive for services rendered. Doctors complain that programs like Medicaid pay less than the cost of treating patients. They say they can't afford to give away too much care.
Lawmakers have also gotten into the debate throughout the country. Utah is no exception.
Recently, the Access to Health-Care Task Force held its inaugural meeting. Its job is to decide what's important for the people of Utah, in the health-care arena.
The majority of the people who are affected by the discussion are low-income. Some can't afford insurance. Some are completely uninsurable under existing programs. Others are seriously underinsured.
I don't envy the task of the panel, which includes three senators, five representatives, personnel from the Human Services and Health departments, advocates for the poor, medical providers and others.
Clearly, the search for solutions will be painful. Rationing of health care will probably be discussed. (That discussion has been taking place in the Division of Health Care Financing, which administers Medicaid and other low-income medical assistance programs. Tough decisions, like one to eliminate bone marrow transplants, have been made because there's a perpetual funding shortage.)
State officials and health-care providers are apt to disagree on certain "realities."
Even if we assume a perfect outcome - that the task force comes up with a solid plan to deal with the crisis - the debate will just be starting. Everyone agrees going in that solutions are apt to be costly indeed. There's no guarantee that there'll be money allocated to act on anything the task force suggests.
Based on recent history, it seems almost unlikely. Too many government programs already vie for state funds. Since there's never enough to go around, no one can say with any assurance that lawmakers will fund whatever emerges from the panel's study.
There's no doubt the state is serious about its quest for solutions. Last session, the Legislature put some money into a risk pool for the uninsured. Participants pay their own premiums - at a rate significantly higher than the average premium. That will help people who can afford insurance but can't get it because of their medical history.
It wasn't enough money to help everyone in that situation. It was a heartening first step.
I hope the task force can come up with the next step. I also hope that the people who can make something good happen will make taking that step a priority.
Thousands of Utahns will be watching. They'll be hoping, too.