Utah made state health insurance available to children without legal status last year. Now, some lawmakers want to change who can receive benefits.
Roughly 1,875 children without legal status are enrolled in the State Children’s Health Insurance Program, or State CHIP, according to the Utah Department of Health & Human Services. The program offers low-cost health insurance to children from working families who meet income requirements and do not qualify for Medicaid.
Rep. Neil Walter has introduced legislation, HB178, that would remove coverage from those here illegally. Two years ago he was a yes vote on Sen. Luz Escamilla’s bill that added eligibility for children in the country illegally.
“I don't think, at the time, I fully understood that we would be using state dollars to pay for health insurance benefits for children without any legal status,” he said.
Escamilla said State CHIP, which was allocated $4.5 million in her bill, saves the state money by decreasing the number of unpaid medical bills.
“It's actually a cost-effective way of addressing the fact that children need access to preventive care,” she said, “and it's better health care outcomes than utilizing [the] emergency room.”
In its State of Children's Coverage Report 2024, the nonprofit Voices for Utah Children said increasing access to health care would likely improve children’s educational outcomes and earning potential — meaning more tax revenue down the road.
Walter said Utah should prioritize its citizens and legal residents.
“I'm more concerned with the incentive or the message than the dollars,” he said. “It's something that we need to be careful about, by essentially advertising or promoting that if you can get to Utah, then we will pay for your health insurance out of citizen funds.”
Escamilla noted a child’s eligibility depends on their parents working. Participants must have also lived in Utah for at least 180 days before applying.
“We can check that they're paying and working here, they're paying into our system,” she said.
People living in Utah without legal status contributed about $235 million in state and local taxes in 2022, according to a report from the Institute on Taxation and Economic Policy. And State CHIP is not free. Families pay coinsurance, copays and deductibles up to 5% of their gross household income.
For Walter, paying taxes shouldn’t qualify people for state support.
“We might have people who travel here, and they visit here, and they spend money and participate in our sales tax system, but that doesn't qualify them for state resources,” he said.
In 2023, Hispanic and Latino children in Utah were three times more likely to be uninsured than non-Hispanic or Latino children. Given that most people in Utah illegally are Hispanic and Latino, this group stands to lose the most if legal status becomes a requirement for coverage.
Data from the Department of Health & Human Services show children from 22 of Utah’s 29 counties are enrolled in State CHIP. Since launching in January 2024, the program has covered over 1,500 wellness visits and more than 600 immunizations.
Ultimately, Walter said other social services could use the funds, like support for people with disabilities or those facing homelessness.
“I'm not trying to say that we don't care about a population or a group, but we are trying to prioritize resources in our state.”
Macy Lipkin is a Report for America corps member who reports for KUER in northern Utah.
KUER’s Elle Crossley contributed to this report.