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Although a national report shows significant improvements to children's health in Utah, advocates fear future progress may be halted by national and state health care reform efforts.

Utah's national ranking jumped from 27th to 19th based on a composite of measures of children's health in 2015, according to the Annie E. Casey Foundation's 2017 Kids Count Data Book, which tracks and publishes the rankings yearly.

More broadly, the report released Tuesday showed statewide improvements in the status of children in several categories, earning Utah a seventh overall ranking for child well-being, based on 2015 data. That reflected gains in economic well-being, education and key indicators related to family and community.

The upswing, though, masks continued struggles of individual children and families across the state, said a spokeswoman for Voices for Utah Children, which released the report.

"They don't care about how we rank compared to Maine or Idaho," Terry Haven said. "The reality is if you are going to bed hungry in Utah, that is what is most important to you."

Fewer children lacking health insurance coverage contributed to boosting Utah's health ranking gains, said Haven. Eleven percent of Utahns 18 and younger went without health coverage in 2010, the report noted, but by 2015, 7 percent didn't have coverage.

Cuts to Medicaid proposed under the American Health Care Act (AHCA) and the uncertainty surrounding Utah's Medicaid expansion, however, could send the state's progress into a tailspin, the group's deputy director added.

"We have made a lot of progress and still have a ways to go," said Jessie Mandle, senior health policy analyst at Voices for Utah Children. "We risk losing the gains we have made and making a U-turn for kids' health if we don't protect and keep moving forward with the progress we have made."

Just short of two-thirds of Utah's Medicaid recipients are children. More than 200,000 of the state's kids get their health insurance either through that low-income program or through CHIP, the Children's' Health Insurance Program.

Restructuring Medicaid under the AHCA could mean changes to eligibility and federal funding to states.

The AHCA may also impact the state's progress in education, another category Utah saw improvement in the Casey Foundation's Kids Count report.

Cuts to Medicaid funding could mean special-education programs in Utah school districts could be significantly reduced or even eliminated, warned Tess Davis, a Voices for Children senior policy analyst.

Many districts, she said, rely on Medicaid funding for physical and occupational therapists as well as specialized equipment for special-education teachers and students.

"Those services provided by schools that use Medicaid dollars would become nonessential under the [AHCA], which means schools could no longer be eligible for their reimbursement" Davis said. "It would make it a lot more difficult for schools to provide special education and interventions like that for kids in our state."

The Casey Foundation report also ranked Utah third nationally in its family and community category, due to drops in the state's teen birthrate and the percentage of children living in families where the breadwinner lacks a high-school diploma. Twitter: @kelgiffo

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