Some 15 percent of children in Utah were uninsured in 2006 — a one-year increase of nearly 3 percent, according to a new census release.

The U.S. Census Bureau's Current Population Survey shows the drop in insured children was largely due to a decline of 23,000 children on government sponsored health-insurance plans, including the State Children's Health Insurance Program for needy children.

However, some health-care advocates see hope in the Legislature's boost to CHIP funding earlier this year, and plans are emerging on the state and federal levels which are aimed at boosting coverage.

Nationally, the number of uninsured children rose by one million from 2004 to 2006, says Leighton Ku, senior fellow for the Center on Budget and Policy Priorities, a Washington policy group that advocates for low- and moderate-income families.

"It's distressing because we were making significant progress in prior years because of CHIP and Medicaid," he says. "The progress has stalled over the last two years, but employer coverage has continued to fall, so we saw a net increase in the number of uninsured children, which is a shame."

In Utah, the number of children who are covered by some sort of health insurance has actually increased — from 668,000 to 681,000 — even though the percentage of children who are covered has declined.

However, it is the percentage, not the overall number, that is the most telling says Karen Crompton, executive director of Voices for Utah Children.

"Percentages show if you're making progress or slipping back on a goal," she says. "The important thing is that kids are losing ground."

The new census survey shows that the percentage of children covered by private insurance has actually increased slightly, but that increase was offset by a drop in children receiving publicly funded insurance, including Medicaid and CHIP. Last September, the state closed enrollment for CHIP, which serves children living at less than 200 percent of poverty; enrollment reopened in July.

The percent of all Utahns, adults and children who are covered by insurance has slipped by a little less than one percent — "clearly still going in the wrong direction," says Judi Hilman, executive director of the Utah Health Policy Project, but at least the percent increase has slowed down, she notes. Between 2004 and 2005, the number of uninsured in Utah rose 2.3 percent and represented the fourth-highest increase in the nation.

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.

The problem, in part, is Utah's aging population and the fact that its economy is dominated by small businesses — which are hurt by the current system in which the major illness of one employee in a small insured group can drive up the premiums of everyone else.

"There's a good chance for lasting health reform in the coming legislative session," Hilman predicts. "But to make sure the right reforms carry the day we're going to need to engage small business owners."

The Utah Health Policy Project is working with an MBA class at the University of Utah's Eccles School of Business to figure out how to engage small business owners, she says.

She defines the "right" reforms as "truly universal, affordable for the neediest ... and flexibility to do creative things with Medicaid and CHIP dollars."

It's important also, she says, to "make sure Medicaid beneficiaries and the poor are also getting good access to prevention and wellness. And we're not there yet."

The group's recommendations will be unveiled on Sept. 25

Meanwhile, Bennett is co-sponsoring a Healthy Americans Act with Sen. Ron Wyden, D-Ore., which would provide private, market-driven insurance.

Calling the rising cost of health care the "biggest single problem we face, outside of the war," Bennett said, "Let's break the link between the employer and health coverage."

He said there would be safeguards built in to ensure that all Americans can receive coverage, but Ku expressed concern that, generally, such plans could eliminate large risk pools. Unader the current system, such pools make coverage more affordable.

"Those policies sound good to those who believe in a free market and individual choice, but they just don't work in the insurance system as we know it," he says. "The people who are the sickest and who need health insurance the most may find themselves much more out of the market."


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