Medicaid

UPDATES:
  • New report released about the Enrollment Barriers New Mexicans are facing with the Affordable Care Act. Read the report here.
  • Center Files Lawsuit in Federal Court on Behalf of New Mexicans Experiencing Roadblocks to Access to Benefits. Read the filing here.
  • New Informational Materials!  Check out our new Healthcare Toolkit & Trainings page for handouts and information on Medicaid, the Exchange and more! (August 2013)
  • Victory! The state will not be ending “retroactive coverage” in Medicaid Medicaid will continue to three months of medical bills a person may have been charged before getting enrolled in Medicaid. Native Americans also cannot be required to enroll into managed care plans except for long term care services. The rest of New Mexico’s “Centennial Care” plan has been approved by the federal government. (July 2013)
  • Native Convening on Medicaid and the Exchange. The Center brought together tribal leaders, providers and advocates to discuss key issues with Medicaid and the Exchange. Learn more at our web page for Native Americans and healthcare.(June 2013)
  • New Mexico says yes to the Medicaid Opportunity! Beginning in January 2014, Medicaid will be available to 170,000 more low-income New Mexicans.
  • Medicaid Rocks! Celebrate the Medicaid Expansion victory by watching our music video! (Jan 2013)
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MEDICAID IN NEW MEXICO

Medicaid is a public program that provides free healthcare coverage for low-income children and adults. Medicaid pays for your care whenever you see a doctor or nurse, go to a clinic or hospital, or visit an Indian health care provider. In New Mexico, Medicaid covers 1 out of every 4 people and provides long term care services for seniors and people with disabilities.

Who Can Get Medicaid?

Medicaid is expanding on January 1, 2014 to provide healthcare to over 160,000 more New Mexicans. You may be able to get new coverage if you are an adult between the ages of 19-64 and your income is under 138% of the poverty level ($15,856 for a single person or $32,500 for a family of four). You can apply starting on October 1, 2013 for coverage that begins January 1st.

Medicaid will also continue to cover children, pregnant women, seniors, and people with disabilities. If you do not qualify for Medicaid, you may be able to get low cost health insurance through a new marketplace called the “Exchange.” For more information, check out our Healthcare Toolkit & Trainings page for handouts, brochures and more in-depth materials.

What Healthcare Services are Covered?

Medicaid covers a wide range of services. Some examples include: routine checkups, prescription drugs, transportation to clinics, hospital care, emergency room visits, maternity care, family planning, home health care, and mental health services. For children, Medicaid is required by law to pay for all medically necessary services including dental care and vision care.

How Do You Apply?

To apply for Medicaid, you will need to submit an application to the Income Support Division (ISD).  Click here for application forms. You may also need to provide documents that prove your identity, citizenship or immigration status, or income if Medicaid cannot find these records in other government databases. See the checklists at the end of our guide on healthcare reform for a list of documents that can be used.

Can Immigrants Get Medicaid?

Many lawfully present immigrants qualify for Medicaid. Some may have to wait for 5 years but many do not have to wait including any lawfully residing children and pregnant women. Even if you cannot get Medicaid due to your immigration status (due to the five year bar or you are undocumented), you can still:

    • Apply on behalf of your children if they are citizens or eligible immigrants. You do not have to give social security numbers or immigration documents for you or other family members who will not be enrolling into coverage.
    • Get coverage for emergencies through a Medicaid program called EMSA (Emergency Services for Aliens).
    • Get free or discounted care at clinics and hospitals. See this guide (in English and Spanish) for more, and review our webpage about healthcare resources for immigrants.
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TRAININGS AND MATERIALS

The Center gives trainings and presentations about Medicaid including information for Native Americans, immigrant communities, and Know Your Rights trainings. For more information and resources, please visit our Healthcare Toolkit & Trainings page.

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GET INVOLVED

Help strengthen healthcare coverage in all of our communities. We will send you updates and alerts about how to get involved and make your voice heard!

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OUR ADVOCACY ON MEDICAID

Our team of attorneys and community organizers work to ensure that New Mexicans can access healthcare coverage through Medicaid. Some of the main issues we are focused on include:

1.     Expand Medicaid enrollment for children and families: New Mexico has made the historic decision to expand Medicaid to over 170,000 more adults. Now it’s time to ensure everyone actually gets enrolled. The state’s Human Services Department has little planned for doing outreach and education. The Center is asking HSD to comply with federal law that requires outreach to be done in underserved communities. We are also spreading the word ourselves by providing trainings, developing informational materials and engaging community groups, schools and other organizations to help with enrollment. We are focused on reaching Native American, immigrant, and other underserved communities where there continue to be significant disparities with children’s enrollment into coverage.

Victory! The Center led a sustained campaign in 2012 to ensure that New Mexico expanded Medicaid. We met with the Governor, researched and obtained expert analysis, widely distributed information, worked with coalition partners, and gave numerous presentations to gain the support of lawmakers, tribal leaders, community organizations, health providers, and the public. Thanks to the efforts of thousands of New Mexicans who reached out to the Governor to make their voices heard, we can now celebrate a historic victory for New Mexico! Check out our dance video on Medicaid Expansion that we showed to the Governor.

 2.     Simplify enrollment procedures and eliminate barriers: There are over 40,000 children who are missing from Medicaid – they are qualified for Medicaid but they are not enrolled. One reason is the application process still prevents many families from applying. We believe the application procedures for Medicaid should be simple and efficient. We continue to enforce the consent decree from the Hatten-Gonzalez v. Hyde class action lawsuit to ensure the application itself is easy to use, fix a problem where newborn babies are consistently losing coverage after their first birthdays because of unnecessary application requests, and ensure that citizen children who live in “mixed status” immigrant families can get coverage.

We have also advocated for several years for New Mexico to adopt “Express Lane Enrollment” that allows the state to find children enrolled in other public programs like SNAP/Food Stamps and automatically enroll them in Medicaid. HSD has received a $1 million federal grant in July 2013 that we hope will be used in part to enroll more kids into Medicaid through express lane.

Victory! The Center advocated for the state to adopt “continuous eligibility” for adults to be able to keep Medicaid coverage for one year even if their incomes change. HSD will begin doing this on January 1, 2014. The state already had continuous eligibility for children – an effort the Center and others advocated for in 2010. At the time, the state also removed the 5 year waiting period for lawfully residing immigrant children and pregnant women due to the efforts of advocates. The state also made major improvements to the Medicaid renewal process in response to an advocacy campaign led by the Center against “autoclosures” where a computer automatically closes Medicaid cases that haven’t been processed within a certain amount of time.

3.     Strengthen coverage levels and protect against cuts: The Center closely monitors Medicaid to prevent cuts to the program that will impact low-income communities. We are advocating for the state to provide a strong benefits package to adults who will become newly qualified for Medicaid starting in 2014. We are asking HSD to provide a comprehensive set of healthcare services that includes preventive dental care. To join our campaign, please contact Kristin@nmpovertylaw.org.

Victory! The Center has been engaged in a campaign for two years to prevent harmful changes to Medicaid proposed by the state’s “Centennial Care” plan to overhaul Medicaid. We organized community members to speak out at public events, generated media, did extensive research, and provided feedback to the state. Youth interns at the Center also captured hundreds of short videos of people enrolled in Medicaid who were opposed to cuts, and delivered these to the Governor. See the videos on our YouTube Channel.  The Center also worked closely with tribal leaders and advocates to oppose certain proposals impacting Native communities. We sent comments to federal CMS officials on the final application and held a phone meeting between New Mexico advocates and CMS.

HSD ultimately decided not to impose extensive fees and co-pays in Medicaid. CMS denied the state’s request to require Native Americans to enroll in managed care (except for long term care services). HSD also will not eliminate retroactive coverage that provides important protections by paying for the past three months of medical bills that a person has been charged before getting enrolled in Medicaid.

Victory! The Center also has closely analyzed the Medicaid budgets each year, providing expert testimony to the legislature and educating the public and lawmakers about the importance of Medicaid. In 2011, we helped commission an independent poll that shows most New Mexicans oppose funding cuts to Medicaid. Although New Mexico faced tremendous challenges with its budget during the economic recession in 2009-2010, Medicaid was one of the only state programs to have its funding mostly preserved, due to the sustained advocacy efforts of the Center, our allies, and key policymakers.

 4.     Strengthen Native American access to healthcare through Medicaid:  The Center worked closely with tribal leaders and providers to assist their efforts to get stronger tribal consultation and oppose parts of the Centennial Care plan that would impact Native American communities.  We continue to support efforts to improve Medicaid. We recently held a Native Convening for leadership, providers, and advocates to prioritize areas for advocacy with the state.  See our Medicaid presentation and handout, Exchange presentation and handout, and Outreach & Enrollment presentation and handout. We are closely working with Jemez Pueblo to provide a series of training on using Medicaid to strengthen the infrastructure of the Indian health system.

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PRESENTATIONS AND MATERIALS

Please refer to our Healthcare Toolkit and Trainings page for informational materials on Medicaid and other healthcare coverage options.

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RESOURCES

PRESENTATIONS & MATERIALS

Please refer to our Healthcare Toolkit and Trainings page for informational materials on Medicaid and other healthcare coverage options.

FACTSHEETS

 Letters/Comments

 Media

 

Links/Resources

  • KidsWell Campaign: state and national advocacy and an organizing campaign to ensure successful implementation of healthcare reform on behalf of children.
  • Georgetown Center for Children and Families: policy and research center working to expand and improve healthcare coverage for children and families nationwide.
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