Utah officials, health-care providers and others are lauding the goals of a diverse national coalition to reduce the ranks of uninsured Americans through tax breaks and an expansion of government programs. But they warn that the plan released Thursday by the Health Coverage Coalition for the Uninsured needs to be more specific if it's to succeed.

The coalition, meeting quietly for almost two years, includes doctors, retirees, business executives and others from groups as diverse as the AARP, U.S. Chamber of Commerce, Families USA and the American Medical Association. The group, sometimes jokingly called "Strange Bedfellows," relied on experts in conflict resolution to resolve differences. And some groups dropped out along the way, including the AFL-CIO and the National Association of Manufacturers.

While the number of uninsured nationally is projected at 46.6 million, the coalition agreed that children need to be covered first, a concept with wide public support. The group also noted that children are less expensive to cover because they usually have fewer health problems.

"We're surprised that such a diverse group could agree on anything," said Mark Fotheringham, spokesman for the Utah Medical Association. "But if they are going to agree on something, protecting our children and making sure they have coverage is the one thing. How to do it is where the devil's going to come out in the details."

Coverage for uninsured children is not a new topic in Utah. In his "state of the state" address, Gov. Jon Huntsman Jr. recommended more than $4 million to add 14,000 more Utah children into the Children's Health Insurance Program, funded by state and federal matching dollars. The governor also spoke of the estimated 300,000 uninsured adult Utahns.

"There has been so much conflict and this is not an easy thing to resolve," said Allan Ainsworth, executive director of the Fourth Street Clinic, which provides care to homeless people in Salt Lake City, of the coalition's plan. "But the announcement's still short on specifics. This is incrementalism. Children certainly have to have health insurance to be healthy, but this is not getting to the lack of coverage for all people in the United States."

The coalition estimates the cost, nationally, of covering children alone at about $45 billion over five years. It envisions a "one-stop shopping" center that would let uninsured children be automatically enrolled in the State Children's Health Insurance Program when they sign up for other means-tested programs such as discount school lunches and food stamps. CHIP covers about 5 million people who live in families with incomes too high to qualify for Medicaid but not high enough to afford health coverage themselves.

The coalition said it expects government to fund its proposed expansion of health insurance coverage, but it declined to say how. They called the plan a "road map" and said they will leave it to Congress to figure out funding.

The how seems obvious to Dr. Joseph Jarvis, chairman of the board of trustees for the Utah Health Policy Project, a nonpartisan and nonprofit think tank. Americans spend more per person for health care than any other nation, he said. And they also pay more taxes. "To begin the policy discussion by suggesting we need dramatic funding is ignoring basic facts. It's not a money problem. It is an efficiency problem."

He said bringing bureaucratic overhead for insurance companies down to 5 percent would be enough. Americans see only 70 cents back as actual health care for every dollar they put in because of high management costs, he said.

The initiative to cover children also creates a new tax credit designed to make it easier for families with incomes below 300 percent of poverty — less than $60,000 a year for a family of four — to pay for insurance for both children and adults.

And the coalition seeks expansion of Medicaid for adults whose incomes are below the poverty level, paid for by unspecified federal funds.

"Our intention was to outline the elements necessary to solve this problem. Our goal was not to write legislative specifications," said a brief outlining the coalition's recommendations.

Kerry Stratford, a family physician in St. George and president of the Utah Medical Association, hailed the work of the group and of an existing Utah health-access-reform task force. "Our frustration is we'd like to see a little faster pace. But it takes time to examine various options and see what's been working in other states and what we could apply to ours. To keep bringing everybody together is a good start."

He said there'd have to be a big enough risk pool and health insurance must be required for everyone, with tax deductions or other help for those who cannot afford it. "There are models that are working," Stratford said.

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