New Mexico Families Celebrate Legislature’s Funding Medicaid Buy-in

Money Appropriated to Study, Develop Innovative Health Coverage Plan

SANTA FE—New Mexico Together for Healthcare on Saturday celebrated a big win for New Mexico families after the Legislature adjourned having appropriated funding to the Human Services Department to further study and begin the administrative development of a Medicaid Buy-in plan, including pursuing federal funding to help pay for it.

“This is a tremendous step forward,” said Strong Families New Mexico Field Director Adriann Barboa. “Because of the leadership of the New Mexico Legislature, our state is leading the nation in moving forward toward creating a Medicaid Buy-in plan so that all families can access quality, affordable healthcare coverage.”

Between the two “Junior” spending bills, SB 536 and HB 548, the Legislature allocated $142,000 for Fiscal Year 2020 for the “study and administrative development of a Medicaid Buy-in plan.”

Initial study of a potential Medicaid Buy-in plan in New Mexico, which was called for by memorials passed in the 2018 legislative session, showed that a buy-in is a cost-effective way to insure the thousands of New Mexicans who are currently without coverage. The additional study called for by the Legislature this year will build on previous research and specifically explore ways to set up the plan to cover the most people possible. The “administrative development” component allows HSD to prepare to implement Medicaid Buy-in, including seeking federal waivers to receive federal financing for the plan.

“No New Mexican should go without healthcare because they cannot afford it,” said Abuko D. Estrada, Supervising Attorney for Healthcare with the New Mexico Center on Law and Poverty. “Without health insurance coverage, though, 190,000 New Mexicans currently have to choose between putting food on the table and seeing a doctor. With the Legislature’s support for Medicaid Buy-in, families will no longer have to make those impossible choices.”

Maria Burciaga, a promotora from Sunland Park, applauded the Legislature for appropriating the funding.

“With many other families, my brother-in-law and I spent as much time as we could over the past two months in Santa Fe talking with legislators, testifying in committees and educating people about Medicaid Buy-in,” Burciaga said. “This funding shows that the Legislature listened to the people. New Mexicans need access to affordable healthcare.”

In addition to the families who spoke out at the Legislature, recent statewide polling found strong support, regardless of political affiliation, for Medicaid Buy-in in New Mexico.

The Medicaid Buy-in is a healthcare coverage plan that would be administered by the state and would allow eligible New Mexico residents to pay affordable monthly premiums to receive the same trusted health coverage that Medicaid has provided for more than 50 years.

“For too long too many New Mexicans have had to choose between paying their bills and getting the healthcare they need,” Colin Baillio, Director of Policy and Communication with Health Action NM said. “New Mexicans—and the members of Legislature–know that it’s time for a change. With this investment in developing a Medicaid Buy-in plan, we will create the change families need and deserve.”

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NM Together for Healthcare is a statewide, multiracial coalition of families and community organizations working together to strengthen healthcare access in New Mexico, supported by Strong Families New MexicoNew Mexico Center on Law and Poverty, Health Action New Mexico and United States of Care. The campaign’s website is http://nmtogether4health.org/ Follow the campaign on Facebook @NMTogether4Healthcare and Twitter @NMT4HC.

Governor reverses Medicaid cuts in Centennial Care 2.0 waiver

Advocacy efforts conclude in a victory for families


SANTA FE—Governor Michelle Lujan Grisham reversed serious cuts to New Mexico’s Medicaid program yesterday following two years of advocacy efforts by the New Mexico Center on Law and Poverty, community organizations, and healthcare providers. Under the Susana Martinez administration, New Mexico’s Human Services Department had proposed major cuts to healthcare services as part of the Centennial Care 2.0 waiver, many of which were approved by the federal Centers for Medicare and Medicaid Services in December 2018.  

The New Mexico Center on Law and Poverty led the efforts to fight the cuts that would have implemented premiums for some Medicaid patients, cut retroactive coverage, and instituted mandatory co-pays.

“We owe a huge thanks to Governor Lujan Grisham for reversing these harmful measures and to the advocates and families who fought tirelessly over the last two years for the health and wellbeing of all New Mexicans,” said Abuko D. Estrada, supervising attorney at the New Mexico Center on Law and Poverty. “Piece by piece, we’ve successfully fought the cuts in the Centennial Care 2.0 waiver that would have led to thousands of families losing healthcare coverage and shifted an unfair burden of costs to healthcare providers and the healthcare system.”  

The governor’s rejection of the waiver is the latest in a series of positive actions the new administration has taken to improve the health and wellbeing of New Mexicans. Since taking office, Lujan-Grisham has set forth plans to reach uninsured New Mexicans who are eligible for Medicaid but not enrolled and help them apply. The governor has also been publicly supportive of bills, currently working their way through the legislature, that would open up a Medicaid Buy-in option for New Mexicans who do not otherwise have access to affordable healthcare coverage.

Taking Medicaid Buy-In to the Legislature

By Abuko Estrada

Affordable healthcare coverage for all New Mexicans could soon be a reality. For the past year and a half, families across the state in the NM Together for Healthcare campaign have been talking to their communities and elected leaders about opening up Medicaid so that anyone could buy into it — even those who don’t qualify for Medicaid currently.

The vision could soon become a reality in the 2019 legislative session. Support is spreading among state policymakers for a Medicaid buy-in plan. Governor-elect Michelle Lujan Grisham has agreed it could be the most viable path towards healthcare coverage for all New Mexicans.

In New Mexico, over 180,000 residents remain uninsured despite coverage gains made under the Affordable Care Act. According to the Kaiser Family Foundation, in 2016, 45 percent of adults said they lacked healthcare coverage due to high costs. Some are locked out of no-cost or subsidized coverage systems altogether. Others, whose incomes are just too high to qualify for Medicaid, still can’t afford coverage even with tax credits provided by the federal government.

A Medicaid buy-in option would take the healthcare coverage affordability issues head-on by leveraging Medicaid to offer individuals and families more affordable coverage than is available through the private marketplace.

With the help of the campaign, communities around the state have voiced their support for the state to provide such an option. The counties of McKinley, Bernalillo, and Doña Ana; the cities of Anthony, Sunland Park, and Albuquerque; and the All Pueblo Council of Governors passed resolutions supporting New Mexico’s exploration of a Medicaid buy-in plan.

Manatt Health Solutions, a policy and strategic advisory group, is helping the state determine the best path for such a plan through a two-phase study. The first phase, which wraps up this month, outlines the pros and cons of different Medicaid buy-in models. The second phase, which should be done by January, will look at the costs to consumers, the impact on hospitals and other healthcare providers, and the costs to the state budget from implementing one or two of the models.

Assuming the study shows a viable path for the Medicaid buy-in, the NM Together for Healthcare Coalition will work closely with legislators to develop legislation for the state to implement the plan as soon as 2020.

To follow Medicaid Buy-in’s progress in New Mexico, please sign up on the NM Together for Healthcare website. Please also call your local representative and senator to let them know you want them to pass Medicaid buy-in legislation during the 2019 legislative session.

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.

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

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.

 

Op-Ed: Underfunding Medicaid is a Foolish Decision

shutterstock baby with doctor for website -2015-12-17by Abuko Estrada & Sireesha Manne

Originally published in the Albuquerque Journal, September 26, 2016. https://www.abqjournal.com/852766/underfunding-medicaid-is-a-foolish-decision.html

As taxpayers, we expect that when government spends our money it will be leveraged toward the best investments that provide the most benefits to our state.

Currently, New Mexico receives four dollars in federal funds for every state dollar invested in Medicaid. This money goes directly into patient care and supports over 50,000 mostly private-sector jobs in the state.

Rather than maximizing this $4 to $1 return on investment, New Mexico underfunded the Medicaid budget in the 2016 legislative session.

For fiscal year 2017, New Mexico is losing over $265 million in federal matching funds for Medicaid by failing to come up with $67 million to meet Medicaid’s minimum budget needs. Our health care system is taking a massive financial loss of over $330 million this year — or nearly $1 million a day!

This is a budgeting disaster for New Mexico that is expected to result in thousands of jobs being lost and, worse yet, a reduction in care to patients. Health care had been one of the only growing job sectors in the state because of the expansion of Medicaid that has added over 4,800 jobs in 2014 alone. However, due to budget shortfalls, the state has decided to reduce Medicaid payment levels for hospitals, doctors and other medical practitioners.

In response, health care providers have issued serious warnings that the low Medicaid rates will force them to downsize staff and potentially even close entire facilities.

The decision to cut Medicaid is self-defeating because New Mexico desperately needs jobs and a stronger health care system.

Nearly every county in the state – 32 out of 33 counties – has shortages for primary care, dental care and mental health care. The problems are most severe for patients in rural areas, where over 30 percent of residents live.

A prime example of health care workforce shortages is the closing of the obstetrics department at Alta Vista Regional Hospital in Las Vegas, N.M. Since 2010, three other hospitals have ceased their obstetric services, forcing expectant mothers to travel unreasonable distances for prenatal care.

Medicaid patients face the most serious consequences of these shortages. The Legislative Finance Committee recently found that up to half of providers in some areas in New Mexico are refusing to take new Medicaid patients.

Another report has found that a quarter of Dona Aña County residents needing hospitalization are going to Texas to get services. However, as illustrated in a recent news article, many doctors in Texas now refuse to see these patients because our state’s Medicaid reimbursement rates are too low.

This is just the beginning.

Medicaid provides health care coverage to two out of three children in New Mexico, as well as seniors, people with disabilities and low-income families. However, due to Medicaid budget shortfalls, the state next plans to cut health care benefits and charge higher patient fees.

Studies have shown that these changes are likely to result in massive losses of coverage for low-income families and will prevent patients from accessing needed services, only deepening New Mexico’s health care crisis.

New Mexico needs to responsibly maximize Medicaid matching funds. The first step is to fix the state’s revenue system. New Mexico is losing needed dollars to tax cuts and loopholes created in the last 15 years for large corporations and the highest-income earners, which have not proven to produce jobs or benefit the state.

There are several ways to raise revenues without hurting working families, such as freezing corporate tax rates at their current levels, which are now on par with other states and further reductions are not needed, taxing capital gains and investment income at the same rate as earned income and targeting products that are undertaxed and that are not necessities, such as new vehicles, alcohol and tobacco.

By not acting, New Mexico is losing precious resources that our state needs to spur job growth and support our health care infrastructure. Let’s put our money into our wisest investments – Medicaid is certainly one of the best.

Op-Ed: State’s decision to cut Medicaid is self-defeating

by Abuko Estrada and Sireesha Manne

Originally published September 19, 2016, NMPolitics.net http://nmpolitics.net/index/2016/09/states-decision-to-cut-medicaid-is-self-defeating/

COMMENTARY: As taxpayers, we expect that when government spends our money it will be leveraged toward the best investments that provide the most benefits to our state. Currently, New Mexico receives four dollars in federal funds for every state dollar invested in Medicaid. This money goes directly into patient care and supports over 50,000 jobs in the state, mostly in the private sector.

Rather than maximizing this $4-to-$1 return on investment, New Mexico underfunded the Medicaid budget in the 2016 legislative session.

For fiscal year 2017, New Mexico is losing over $265 million in federal matching funds for Medicaid by failing to come up with $67 million to meet Medicaid’s minimum budget needs. Our health-care system is taking a massive financial loss of over $330 million this year – or nearly $1 million a day!

This is a budgeting disaster for New Mexico that is expected to result in thousands of jobs being lost and, worse yet, a reduction in care to patients. Health care had been one of the only growing job sectors in the state because of the expansion of Medicaid, which added over 4,800 jobs in 2014 alone.

However, due to budget shortfalls, the state has decided to reduce Medicaid payment levels for hospitals, doctors and other medical practitioners. In response, health-care providers have issued serious warnings that the low Medicaid rates will force them to downsize staff and potentially even close entire facilities.

The decision to cut Medicaid is self-defeating because New Mexico desperately needs jobs and a stronger health-care system. Nearly every county in the state – 32 out of 33 counties – have shortages for primary care, dental care, and mental health care. The problems are most severe for patients in rural areas, where over 30 percent of residents live.

A prime example of health-care workforce shortages is the closing of the obstetrics department at Alta Vista Regional Hospital in Las Vegas. Since 2010, three other hospitals have ceased their obstetric services, forcing expectant mothers to travel unreasonable distances for prenatal care.

Medicaid patients face the most serious consequences of these shortages. The Legislative Finance Committee recently found that up to half of providers in some areas in New Mexico are refusing to take new Medicaid patients.

Another report has found that a quarter of Dona Aña County residents needing hospitalization are going to Texas to get services. However, as illustrated in a recent news article, many doctors in Texas are now refusing to see these patients because our state’s Medicaid reimbursement rates are too low.

This is just the beginning. Medicaid provides health-care coverage to two out of three children in New Mexico, as well as seniors, people with disabilities and low-income families. However, due to Medicaid budget shortfalls, the state next plans to cut health-care benefits and charge higher patient fees.

Studies have shown that these changes are likely to result in massive losses of coverage for low-income families and will prevent patients from accessing needed services, only deepening New Mexico’s health-care crisis.

New Mexico needs to responsibly maximize Medicaid matching funds. The first step is to fix the state’s revenue system. New Mexico is losing needed dollars to tax cuts and loopholes created in the last 15 years for large corporations and the highest income earners, which have not proven to produce jobs or benefit the state.

There are several ways to raise revenues without hurting working families, such as freezing corporate tax rates at their current levels, which are now on par with other states and further reductions are not needed; taxing capital gains and investment income at the same rate as earned income; and targeting products that are being under-taxed and that are not necessities, such as new vehicles, alcohol and tobacco.

By not acting, New Mexico is losing precious resources that our state needs to spur job growth and support our health-care infrastructure. Let’s put our money into our wisest investments – Medicaid is certainly one of the best.

Abuko Estrada and Sireesha Manne are attorneys with the New Mexico Center on Law and Poverty.