McKinley County Commission unanimously supports innovative ‘Medicaid buy-in’

Community need and widespread support inspired commission

GALLUP–The McKinley County Commission, after hearing powerful community testimony, on Tuesday unanimously passed a resolution in support of the state’s work to develop and implement an innovative plan to allow New Mexicans the opportunity to buy-in to the proven, trusted Medicaid healthcare system.

“With more than 16,000 McKinley residents still uninsured,” said Christopher Hudson from the McKinley Communities Health Alliance “We need to support innovative ideas that will help everyone in our communities get the health care they need. A Medicaid buy-in program is a great option to make quality care affordable and accessible.”

In the 2018 Legislative Session, both the House and the Senate passed memorials calling for the Legislative Health and Human Services Committee to explore the policy and fiscal implications of offering a Medicaid Buy-in plan to New Mexico residents.

By allowing McKinley County residents to buy-in to Medicaid for their health coverage, a state program would reduce uncompensated care for doctors and hospitals and would also save much-needed funding in the county’s indigent care funds.

“I know how hard it can be to access health care,” said McKinley County resident and Strong Families New Mexico healthcare advocate Althea Yazzie. “I’ve had to fight with insurance providers to get help to pay for my medications, my transportation, and my rheumatologist appointments. Being sick is hard. Getting better shouldn’t be. I’m proud of our county for supporting Medicaid buy-in.”

In addition to sharing the resolution with legislators to show the county’s support for a Medicaid buy-in plan, the resolution also adds Medicaid buy-in to McKinley County’s legislative priorities, meaning the county will work directly with legislators to advance the program.

Court finds management problems prevent HSD from fixing food and medical benefits applications

ALBUQUERQUE—A federal court found that lack of leadership and accountability in the New Mexico Human Services Department prevents it from fixing entrenched problems in food and medical benefit administration.

In a ruling issued late yesterday, U.S. District Court Judge Kenneth Gonzales set a series of deadlines for HSD compliance with court ordered reforms and required the appointment of knowledgeable subject matter experts in supplemental nutrition assistance program (SNAP), Medicaid, and eligibility for families that include immigrants in the department’s Income Support Division.

“We’re very hopeful that this ruling will lead to much needed changes in the department’s leadership,” said Sovereign Hager, managing attorney at the New Mexico Center on Law and Poverty. “For there to be permanent improvement in administration, the Human Services Department leadership must have expertise and management abilities that give front line workers the tools they need to ensure New Mexicans can get food and medical assistance. HSD is still not processing applications in time, leaving too many children and families unable to access basic necessities.”

In September 2016, Judge Gonzales held the HSD Secretary Brent Earnest in contempt for failing to remove barriers to assistance for eligible families. The court appointed a Special Master to monitor and make recommendations to the department.

Despite court orders and the expertise provided by the Special Master, HSD continues to improperly deny eligible New Mexicans food and medical assistance and does not provide timely information about case decisions. Each month the department develops a backlog of unprocessed cases, a large share of phone calls go unanswered, and workers are not accurately trained on the requirements for processing food and medical assistance applications.

In his ruling yesterday, the judge agreed with the Special Master’s January 2018 report finding that the current HSD management team lacks the sufficient “knowledge, skills, and abilities” necessary to ensure families receive information about their cases and get the assistance they need to eat and see the doctor.

The judge also found that the Income Support Division Director demonstrated “woefully” little knowledge of the court ordered changes to improve processing food and Medicaid applications despite the significant impact they had on the division’s mission and work.

The judge was also troubled by the ISD Director’s lack of knowledge of standard memoranda issued by her division, training procedures, and her admitted failure to speak with the Regional Operations Managers on how to address improving timeliness and efficiency.

“We hope the state will make the management changes that will end the need for such extensive oversight through the courts,” said Hager. “New Mexicans who are going through significant hardships shouldn’t have to fight with the state to get the food and medical care they need.”

Center attorneys working on the Deborah Hatten Gonzales v. Brent Earnest lawsuit include Sovereign Hager, Gail Evans, and Maria Griego. Civil rights attorney, Daniel Yohalem is lead counsel on the case.

The court’s ruling can be found here: http://nmpovertylaw.org/wp-content/uploads/2018/04/Doc.-836-Memorandum-Opinion-and-Order-2018-04-05-00000003.pdf

Action Alert: Thank you for joining us in making healthcare accessible for all New Mexicans! 

Good news! The memorials to study a Medicaid buy-in option in New Mexico – House Memorial 9 and Senate Memorial 3 – both passed with strong bi-partisan support. The study is a first step toward an innovative new plan that would allow individuals and families in our state to buy low-cost coverage through Medicaid even if they do not qualify for it now. This would provide more people with affordable healthcare and create more choices in the insurance market.

This would not have happened without you. Thank you for joining us in acting to strengthen healthcare access for all New Mexicans!

Your advocacy means that our state Legislative Health and Human Services Committee will bring together experts and stakeholders to explore whether the Medicaid buy-in is a viable option for uninsured and under-insured New Mexicans.

If you have not already, please follow the New Mexico Together for Healthcare campaign to get updates and alerts about how you can take action to support the Medicaid buy-in study. You can sign up here to get involved and follow the campaign on social media – Twitter (@NMT4HC) and Facebook (@NMTogether4Healthcare) – and its website.

For additional details, please also see our factsheet. For any questions, do not hesitate to contact us.

Proposed cuts to Medicaid in Trump budget would have devastating impact on New Mexico

ALBUQUERQUE, NM — The proposed cuts to Medicaid in the Trump administration’s budget for fiscal year 2019 would prevent hundreds of thousands of New Mexicans from accessing healthcare. The budget, if approved by Congress, would cut Medicaid by $1.4 trillion dollars between 2019-2028; eliminate critical funding for Medicaid expansion, which provides over 250,000 New Mexicans with healthcare coverage; and end subsidies that help individuals and families when buying insurance through the marketplace.

“The drastic cuts to Medicaid would make healthcare unaffordable for millions of Americans and hundreds of thousands of New Mexicans,” said Abuko D. Estrada, attorney for the New Mexico Center on Law and Poverty. “After handing out tax cuts to the richest households, the administration now wants to cut Medicaid by over a trillion dollars in the next decade. This would devastate New Mexico’s budget or force our state to ration healthcare to children, the elderly, people with disabilities, pregnant women, and low-income adults.”

The budget proposes the same cuts to Medicaid as last year’s bills in Congress to repeal the Affordable Care Act. It would cut funding for Medicaid and restructure the program into a per capita cap system. This would give New Mexico a set amount of Medicaid funding to spend per person rather than a federal match for the state’s actual costs. If New Mexico’s Medicaid costs grow faster than the cap amount, the state would be forced to make deep cuts to Medicaid benefits, services, and even eligibility.

A study last year conducted by the UNM Robert Wood Johnson Health Policy Center found that the combined Medicaid cuts could cost New Mexico more than $400 million per year or cause more than 250,000 people to lose coverage.

‘NM Together for Healthcare’ launches campaign for affordable healthcare for all New Mexicans

Statewide effort includes an innovative Medicaid buy-in plan

ALBUQUERQUE, NM: On Friday, New Mexico organizations and individuals launched NM Together for Healthcare, a campaign to make good healthcare affordable for everyone in the state. The campaign includes an initiative to advance an innovative Medicaid buy-in plan to expand access to quality, affordable healthcare.

“We are all equal in deserving health care,” said Alfonso Yazzie, healthcare leader from Yah-ta-hey, New Mexico.

In the upcoming Legislative Session, NM Together for Healthcare will be supporting state Sen. Jerry Ortiz y Pino and state Rep. Debbie Armstrong’s memorials to explore a Medicaid buy-in plan for New Mexico. The buy-in—a concept that is gaining momentum nationally with similar bills introduced in Congress and currently in progress in Massachusetts, Illinois, and Iowa—opens up Medicaid to allow more consumers to buy low cost coverage through a Medicaid plan. This provides people with affordable health care and creates more choices in the insurance market.

“Our work will not be done until all New Mexicans have access to affordable, quality health care,” said Armstrong, chair of the House Health and Human Services Committee. “We need innovative policies like Medicaid buy-in to make sure all families are cared for.”

NM Together for Healthcare began its campaign after hearing from New Mexicans that despite recent improvements through the Affordable Care Act, quality health care is still out of reach for many.

“My father worked as a custodian for 30-plus years in the schools,” said Maximina Urritia, a healthcare leader from Anthony. “After retiring, both my parents fell ill. With no insurance, and a budget of $700 per month from my dad’s retirement, they knew they could not afford the medical attention or medications they needed. Without that care, they died too early. Healthcare would have saved my parents lives.”

Currently, more than 180,000 New Mexicans, like Maximina’s parents, don’t have healthcare coverage.

“No one should have to go without healthcare because it is too expensive,” said Sireesha Manne, healthcare supervising attorney at the New Mexico Center on Law and Poverty, “Medicaid already helps more than 850,000 New Mexican children and families get comprehensive care, and could be opened up to everyone as a low-cost option. The buy-in plan is a promising solution.”

The campaign’s website can be found at: http://nmtogether4health.org/

Follow the campaign on Facebook @NMTogether4Healthcare and Twitter @NMT4HC.

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NM Together for Healthcare is a statewide, multiracial campaign of families and community organizations working together to strengthen healthcare access in New Mexico, supported by Strong Families New Mexico and New Mexico Center on Law and Poverty

 

 

Action Alert: Last chance to stop harmful Medicaid cuts in New Mexico

We have one last chance to stop the harmful Medicaid cuts that Governor Martinez and the Human Services Department are proposing in the Centennial Care 2.0 plan! Co-pays, premiums, eliminating retroactive coverage, and ending other important benefits will not make Medicaid better.

These major cuts will cause thousands of low-income New Mexicans to lose healthcare coverage, shift more costs to healthcare providers, and raise overall costs for our healthcare system and state budget. The cuts will also deny our children and families access to timely and appropriate care, forcing them to wait until medical conditions worsen into emergencies before seeking medical attention.

Please call and urge your networks to contact Governor Martinez at (505) 476-2200. Tell her to stop Medicaid cuts by withdrawing the proposals for premiums, co-pays, eliminating retroactive coverage, and other damaging cuts to benefits and services. Please call her this week before HSD submits its final proposal to the federal government.

 

UNM Hospital Stops Requiring Low-Income, Uninsured Patients to Pay 50 Percent Down Payment for Surgery

ALBUQUERQUE, NM–After months of intense pressure from advocates, the UNM Hospital Board of Trustees reversed a policy, implemented in May 2017, requiring low-income, uninsured patients to pay a 50 percent down payment before surgeries. As a result of the policy, the hospital cancelled many patients’ surgeries because the patients couldn’t come up with thousands of dollars upfront to repair hernias, torn knee ligaments, broken bones, and in one case, a hysterectomy.

“We are relieved that the Hospital Board of Trustees has finally decided to treat all people with the same compassion and standard of care that insured people receive,” said Michelle Melendez, director of EleValle: South Valley Healthy Communities Collaborative. “Requiring people to pay 50 percent upfront was inhumane and not consistent with the mission of our public safety net hospital, which receives $96 million per year in property tax revenue to help cover indigent patients.”

The EleValle collaborative, which is comprised of Casa de Salud, Centro Savila, and ACCESS, teamed up with the New Mexico Center on Law and Poverty, Juntos Para la Salud, and with patient navigators from Pathways to a Healthy Bernalillo County to educate the UNM Hospital Board of Trustees about the policy’s impact on low-income, uninsured residents of Bernalillo County. The Bernalillo County Commission and the state Legislative Health and Human Services Committee weighed in on the side of advocates.

“The hospital’s policies created an insurmountable barrier for low-income patients to get surgeries, impacting their livelihoods and forcing them to suffer through worsening medical conditions,” said Sireesha Manne, healthcare attorney at the New Mexico Center on Law and Poverty. “We are grateful for the collaborative effort of community groups, patient navigators, and policymakers to hold the hospital accountable to its public mission.”

The board voted unanimously at the hospital’s board meeting on Friday to change the hospital’s Patient Payment and Financial Assistance policies. It also voted unanimously to establish a new Discount Program Policy for low-income patients living in New Mexico who meet poverty guidelines, are ineligible for Medicaid, and unable to purchase private insurance on the Health Insurance Exchange.

The new policies reinstate the hospital’s affordable down payment schedule that had been in place from 2005 until May 2017. Pathways navigators became aware of the hospital’s change in policy when clients who were seeking help with food, housing, transportation, and other basic needs disclosed that they were unable to work because of knee injuries and other debilitating medical conditions but could not afford a 50 percent down payment.

The reinstated schedule allows patients to pay $25, $75, or $300, depending on their level of poverty, upfront for surgeries that have been deemed medically necessary by their healthcare providers. The patients are then required to make monthly payments on the balance owed, which could be tens of thousands of dollars.

At the Friday meeting, Jerry McDowell, UNM Hospital board chairman, said, “There are some basic values that I think guide us: Do no harm to the patient. Consistent with our public service mission, serve all individuals with fairness, respect and dignity. Strive for best in class for quality, safety, and care. There are also legal guidelines overarching.”

Human Services Department to Hold Hearing on Medicaid Cuts on Monday, October 30

ALBUQUERQUE, NM—New Mexico’s Human Services Department (HSD) will hold a hearing on the serious cuts the Medicaid program faces in the Centennial Care 2.0 waiver proposal on Monday, October 30 at the National Hispanic Cultural Center in Albuquerque. This will be the final public hearing on the issue.

The waiver proposal eliminates important coverage and health benefits and imposes new excessive patient fees in the form of co-pays and premiums on the working disabled, low-income adults living just above the poverty line, and children enrolled in the Children’s Health Insurance Program (CHIP). These fees will prevent people from seeking necessary healthcare and cause thousands of others to lose coverage.

WHAT:
HSD Hearing on the Centennial Care 2.0 Waiver Proposal

WHEN:
5:30-7:30 p.m., October 30, 2017

WHERE:          
National Hispanic Cultural Center’s Bank of America Theatre
1701 4th Street SW
Albuquerque, NM, 87102

Call in Number: 1-888-757-2790
Participant code: 991379#

WHO:

  • HSD staff
  • Abuko Estrada, attorney at the New Mexico Center on Law and Poverty and other groups against the waiver
  • Public Comment

Healthcare Repeal Effort Comes to an End, Saving Medicaid Funds for New Mexico

WASHINGTON DC— Republicans in Congress decided today to end their push on the Graham-Cassidy bill to repeal the Affordable Care Act, because they do not have enough votes in their party to pass it through the Senate. Their decision comes after the Congressional Budget Office released a preliminary report yesterday that concluded millions of Americans would lose their healthcare coverage under the legislation, mostly due to significant cuts to Medicaid. The bill would have ended Medicaid Expansion for low-income adults and resulted in New Mexico losing billions of federal dollars over the next ten years.

“Medicaid has greatly improved the physical and economic health of New Mexico,” said Sireesha Manne, an attorney with the New Mexico Center on Law and Poverty. “This bill suffered the same problems as older versions. It would have ripped away healthcare coverage from millions of people and permanently damaged Medicaid – a cornerstone of our healthcare system.”

The bill would have ended the Medicaid Expansion that provides healthcare coverage to more than 255,000 low-income adult New Mexicans, and resulted in New Mexico losing $9 billion federal dollars by the year 2027, according to the nonpartisan research group Avalere. The bill capped funding for the entire Medicaid program and eliminated tax credits that help people buy insurance. States would have been allowed to let insurance plans stop covering essential health benefits and to charge more to consumers with pre-existing conditions.

“New Mexico would have been forced to pay billions more in healthcare costs or slash Medicaid coverage for more than 230,000 people and cut services for the most vulnerable populations – including children, seniors, and people with disabilities,” said Manne.

The bill faced widespread opposition from state officials, consumer groups, and medical and industry groups. It also proved to be unpopular among Americans, with a CBS News Poll showing 52% of respondents disapproving the bill and only 20% in approval. A statewide poll conducted in New Mexico earlier this year by Research & Polling, Inc. found that nearly three-quarters of New Mexicans are opposed to reducing federal funding for Medicaid, and four out of five voters believe Medicaid is “important” or “very important” to residents.

Legislative Health and Human Services Committee to Hold Hearing on Medicaid Cuts Today

ALBUQUERQUE, NM—The New Mexico Legislative Health and Human Services (LHHS) Committee will hold a hearing today, starting at 12:30 p.m., on the serious cuts the Medicaid program faces in the Human Services Department’s (HSD) Centennial Care 2.0 waiver proposal. The hearing will take place at the Science and Technology Center Rotunda at UNM, 801 University Blvd. SE in Albuquerque, NM.

The proposal eliminates certain coverage and health benefits for low-income patients and imposes new patient fees in the form of co-pays and premiums to children enrolled in the Children’s Health Insurance Program (CHIP), the working disabled, and low-income adults living just above the poverty line.

“Medicaid has worked well for New Mexico. The state should focus on ensuring our families can get the care they need to stay healthy, not cut coverage for the people who can least afford it,” said Abuko D. Estrada, an attorney with the New Mexico Center on Law and Poverty. “At a time when our economy is struggling, these cuts will drive families into further financial hardships and throw away federal funding that helps sustain thousands of jobs.”

Currently for every state dollar New Mexico invests in Medicaid, the state receives four dollars back from the federal government. The Centennial Care 2.0 waiver proposal cuts will result in the loss of federal money for Medicaid that supports over 50,000 jobs and helps drive the New Mexico economy.

Centennial Care 2.0’s most harmful cuts to Medicaid include:

  • Charging low-income patients with new fees in the form of co-pays and premiums for children in CHIP, the working disabled, and low-income adults living just above the poverty line, which could result in thousands of people losing coverage altogether (as studies have shown);
  • Eliminating retroactive coverage protection that pays for Medicaid applicants’ past medical bills, from three months prior to applying for Medicaid, putting New Mexico’s families in severe medical debt and leaving healthcare providers with uncompensated care costs;
  • Ending a transitional Medicaid program that will result in coverage loss for families that have been living in deep poverty, creating financial hardships and interrupting health coverage when they enter new jobs or accept raises that place them just above the eligibility threshold for Medicaid; and
  • Reducing important health benefits for very low-income adults with dependent children, eliminating Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) protections for children who are 19 and 20 year olds, and opening the door for the HSD secretary to make drastic cuts to more benefits in the future.

WHAT:
LHHS Committee Hearing on the Centennial Care 2.0 Waiver Proposal

WHO/WHEN:       
12:30 p.m.
Presentations about Concerns about Medicaid Cuts
Abuko D. Estrada, Attorney, New Mexico Center on Law and Poverty
David Machledt, Ph.D., Senior Policy Analyst, National Health Law Program

2:30 p.m.
Presentation on Medicaid Waiver
HSD Secretary Brent Earnest

4:30 p.m.
Public Comment

WHERE:   
Science and Technology Center Rotunda at UNM
801 University Blvd SE
Albuquerque, NM

Today’s hearing will be the only opportunity for providing comments in Albuquerque. Other public meetings will take place in Santa Fe, Las Cruces, and Las Vegas.