The state then stores this information in the All Payers Claims Database (APCD). Once there, all that is required for the release of this information for research purposes is for an unelected state employee to determine that “the value of the research is greater than or equal to the infringement upon personal privacy.”

But it doesn’t stop there. The state provides a digital copy of the APCD to the University of Utah where it is maintained in the Utah Population Database, which has 620 million APCD records plus another 204 million records obtained from the Centers for Medicare and Medicaid Services. In addition, the One Utah Health Collaborative, which, according to legislative auditors, is a 501c3 founded by the governor, has been given access to APCD data. This is done without receiving the consent of those whose records are being spread far and wide.

Entities can then link an individual’s insurance claims together by using their name, date of birth and social security number. Therefore, the state and others with access to the APCD are able to use diagnostic codes to compile a complete health profile of each and every Utahn who has health, dental and prescription drug insurance. They know if an individual is vaccinated, has dentures, takes antidepressants, uses birth control, has been diagnosed with autism, is cognitively impaired, receives treatment for impotence or infertility, has cancer, is receiving counseling, and everything else that has been submitted for payment by an individual’s insurance carrier.

Entities that maintain these databases are subject to unrelenting pressure from researchers and a wide range of governmental and private entities who want access to these extremely valuable records. However, when Dr. Zimmerman (one of the authors of this article) asked to see who her records had been shared with, she was informed that those managing the APCD didn’t know.

Recently, legislative auditors looked at the APCD and its use. However, in keeping with Governor Cox’s Executive Order 2023-01 that calls for increased data sharing, rather than evaluating how well Utahns’ PII and highly sensitive medical records are protected, the audit called for greater data sharing while bemoaning the fact that it is “easier for external requestors (such as university researchers) to access APCD data than internal DHHS staff.”

The auditors then recommended that the Legislature consider policy options that allow for still more data sharing within DHHS and that the Legislature consider balancing the need for more robust behavioral health metrics with data privacy principles. The audit also recommended that the Legislature look at increasing revenue from data user fees.

Opinion: Utah must lead the legal fight to protect our health privacy

Given the highly sensitive nature of this PII and medical information, we would suggest that, rather than making it easier to access APCD data, the following three things be done:

First, the state auditor should conduct a comprehensive audit to determine if the state has the legal authority to collect Utahns’ data for the APCD without their consent, the legal authority that permits the sharing and selling of APCD data, who the data has been shared with, how shared data is protected by the recipients, if the shared data has been re-disclosed to others, and if all transfers and redisclosures of APCD data have been done legally.

Second, all health insurance providers should be required to notify Utahns in a conspicuous place on their websites and on all insurance claims forms that their PII and medical claims information is being provided to the APCD and that it may be shared with other entities.

Third, the transfer of any APCD data by DHHS, either in limited data sets or in total, to researchers or other entities, should be prohibited unless the written, informed consent of each person whose PII and sensitive medical information being transferred is obtained.

In many of these districts, irrigation water actually plays a critical role in replenishing the aquifer that their culinary wells draw from. In addition, the mandate doesn’t factor in the adverse effects that it has on the people who have paid to build and maintain the irrigation water systems over the past 50 years, on urban “heat islands” and on vegetation that reduces carbon dioxide levels.

Engineering studies have shown that in water districts where much of the soil consists of sand and gravel as much as 40% of aquifer recharge is due to irrigation water. So, water managers have to balance the need for conservation with the need to maintain the culinary aquifer. Unfortunately, the Legislature’s proposed mandate doesn’t acknowledge this.

In addition, the majority of the smaller, “affordable” homes in the district I reside in were built in the 1950s and ’60s. They have fully landscaped yards with mature trees, shrubs, fruit trees and garden plots that contribute to the physical health and mental well-being of seniors who keep active by working in their yards.

During the COVID-19 lockdowns when schools and public parks were closed, these yards provided safe spaces for neighborhood children to socialize. In addition, in my area these irrigated yards mitigate the urban “heat island” effect while the trees and other vegetation absorb carbon dioxide. But the mandate ignores all of this.

If the small district providing my irrigation water is required to install water meters, it may be forced to charge more for irrigation water than for culinary water, since the cost to install and maintain meters on aging galvanized lines in fully landscaped backyards will be in the range of $2,000 each. Even with grant money covering 50% to 70% of the installation cost, irrigation water fees will have to increase substantially — and that doesn’t include the cost of maintaining and reading the meters. And under the mandate, the only thing the meters will do is encourage people to voluntarily use less water since people will not be charged based on water used.

Given this, some people may resort to using culinary water for irrigation purposes rather than installing meters. Should that occur it would seriously stress the culinary aquifers and could eventually result in a system collapse.

Another factor to consider is that in some areas where irrigation water consumption has dropped by 30%, homes are sinking as the water table drops and the ground subsides under them. It is not known if the water table is falling due to water conservation, the drought, a combination of the two or some other unknown factor(s). However, there were no similar problems during past droughts.

Furthermore, many of the state’s water districts have aging, leaky irrigation and culinary water pipes and so it makes more sense to use the money required to install the mandated meters to deal with these issues. Sadly, they can’t afford to do both.

Finally, there are far more frugal, less authoritarian ways to achieve water conservation and, even more importantly, to balance irrigation water usage with the health of culinary aquifers. For example, one district sharply reduced usage by spending less than $2,000 to mail out postcards asking its customers to reduce irrigation water consumption.

That district could continue to mail postcards for the next 2,000 years for the cost of installing water meters that wouldn’t give any better results. In addition, xeriscaping of existing properties, large lots being converted into high density housing that don’t use irrigation water and other initiatives will continue to reduce irrigation water consumption.

In sum, just like federal mandates, state mandates are costly, they frequently impact those least able to pay and they override elected representatives who are charged with balancing the use of irrigation water with the preservation of culinary aquifers. It’s important to remember that Utah is not Washington, D.C., and mandates are not the Utah way.

As one legislator recently said, “Doing something for the sake of doing something is not a good enough justification for a government mandate.”

Ronald Mortensen, Ph.D., is a retired foreign service officer and a resident of Bountiful.

But it is more than just a matter of trust. If the Democratic and Republican parties are allowed to require Utahns to give them their personal identifying information as the price to vote, that could be seen as a form of poll tax.

A poll or head tax is imposed equally on all adults at the time of voting. It was used in the South during and after reconstruction as a means of getting around the 14th Amendment and denying blacks their right to vote. The 24th Amendment made poll taxes illegal as a prerequisite for voting.

At the present time, voters in Utah can register to vote without making their personal identifying information available to political parties and to potentially 7.7 billion people worldwide who can find their information on voterrecords.com once it is sold by the lieutenant governor’s office for $1,050. Roughly 15% or 250,000 registered voters have elected to make their records private even though most Utahns still don’t know that they can protect their voter records.

Now, in a rare bipartisan effort, Utah’s Democratic and Republican parties say this voter privacy must end. A bill has been introduced into the legislature, SB83, that denies the average person the right to make their voter records private while allowing elected officials and prominent people to make their records private. 

Under SB83, the names, addresses and phone numbers of victims of domestic violence, of children who testified in child abuse cases and of law enforcement officers and judges who don’t provide justification for keeping their records private will have their information given to the two major political parties, to candidates, to their agents and to their independent contractors.

And if SB83 passes the legislature, all of Utah’s currently registered voters who refuse to give their extremely valuable personal information to the Republican and Democratic parties will have no option but to cancel their voter registrations and be denied their right to vote.

Individuals who are not already registered to vote will have to provide their personal identifying information to the Democratic and Republican parties if they want to vote.

SB83 raises a series of questions.

Should the right to vote be dictated by the Democratic and Republican parties when 40% of all registered voters in Utah don’t belong to either of those parties?

Should the Democratic and Republican parties have access to the information of 600,000 unaffiliated voters?

Should the quarter of a million voters who have already made their voter records private be forced to cancel their voter registrations in order to protect their privacy? 

Should the taxpayers be stuck with the $145,000 bill that is attached to SB83?

And since an individual’s personal identifying information is a highly valued commodity, is requiring voters to give this information to the Democratic and Republican parties as the price required to exercise their right to vote a de facto poll tax?

Legislators would do well to remember that they recently found themselves aligned against the people on tax reform because they did as their leadership asked rather than what the people wanted. If legislators deny voters the right to make their information private because their parties tell them to do so they will once again find themselves aligned against the people and will have to face the consequences.

Ronald Mortensen is a retired foreign service officer and a citizen lobbyist who works to protect the privacy of personal identifying information that Utahns are required to give to the state and to local governments.