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With new figures showing that more Utahns are living in poverty, advocates gathered Saturday to discuss policies to help those growing ranks, including expanding Medicaid and maintaining low-cost mass transit.

Jennifer Hyvonen, with the Fourth Street Clinic, suggested health care is as important to the state's economic development as the tax incentives Utah gives to companies to relocate here.

"For us, Medicaid expansion is an investment in Utah so we can have a strong economy, so people can continue to work, so people can pay taxes," said the external affairs director of the health care clinic that treats homeless Utahns.

As one of the speakers at the Ninth Annual People's Summit on Poverty held in Salt Lake City, Hyvonen was preaching to the choir. The 50 or so attendees of the summit at Crossroads Urban Center work with low-income, disabled and minority Utahns.

Newly released data from the U.S. Census Bureau's one-year American Community Survey found 13.5 percent of Utahns — and nearly 16 percent of children — lived in poverty last year. Poverty is defined as a family of four earning $22,350 or less in gross annual income.

As a result of the U.S. Supreme Court ruling on the Affordable Care Act, states have the option of expanding Medicaid to cover all poor adults. Today, poor adults who wish to qualify for coverage must have dependent children or be disabled.

Hyvonen told a story of a man who lost his job and dental insurance. His bleeding gums led to heart failure, which led to a heart-valve replacement surgery. Due to complications, he became disabled and can no longer work.

If he had had proper medical care early on, Hyvonen said, he wouldn't "be on the dole" for the rest of his life.

But Norman Thurston, health reform implementation coordinator for Gov. Gary Herbert, told the summit that expansion is not so easy. He said it will cost the state $25 million a year to add another 100,000 Utahns to Medicaid. Plus another $100 million to cover the 58,000 Utahns who are now eligible but aren't on Medicaid. The costs will double in 10 years as the federal government reduces its share of the tab.

"This is what makes the whole discussion difficult at the governor's office level," he said."It's not so much about not wanting to help somebody. It's this in-your-face problem of where do I come up with $125 million a year?"

Hyvonen countered that the state should enroll the working poor in the program and get their health stabilized in the first three years, when the government will pay 100 percent of the costs. Then hopefully their health becomes better, and costs are consequently lower when the state has to start paying, she said.

Summit participants also told a Utah Transit Authority representative to ensure that the cost of train and bus trips remains low for people on fixed incomes, who rely most heavily on mass transit.

UTA is considering moving to a distance-based fare system, in which riders pay based on how far they travel, instead of the flat $2.35 one-way fare.

UTA spokeswoman Andrea Packer told the group that riders taking trips within the city will likely pay less, though UTA is still analyzing the costs.

But instead of calculating just fees, UTA should focus on reducing air pollution, suggested Brian Moench, president of Utah Physicians for a Healthy Environment. Noting that pollution harms poor people more than anyone — they are most likely to live by polluting industries and freeways — Moench said they shouldn't be "victimized further in the fee structure the UTA comes up with."

UTA will decide by early next year if it will move forward with a distance-based proposal, and then seek public comment.

Thoughts about Medicaid expansion?

The Utah Social Services Appropriations Subcommittee is meeting Thursday from 8 a.m. to noon to take public input about health care reform. Public input is tentatively scheduled to start at 11 a.m. To speak, you must contact Debbie Benson at 801-538-1034 before 2 p.m. on Tuesday.

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