Trump’s new rule would roll back civil rights protections in healthcare law

Nondiscrimination protections under the ACA are at risk

ALBUQUERQUE—In a move that will especially harm trans people, the LGBTQ+ community, patients who speak languages other than English, and people who need access to abortion services, the Trump administration proposed rolling back enforcement of nondiscrimination protections under the Affordable Care Act. New Mexico advocates who champion access to healthcare urge New Mexicans to publicly oppose Trump’s latest threat to healthcare accessibility.  

The ACA’s landmark nondiscrimination provision, known as Section 1557 or the Health Care Rights Law, protects patients from discrimination based on race, color, national origin, sex, age, and disability. Comments on proposed changes to Section 1557 must be submitted with the Federal Register by August 13, 2019.

“Discrimination has no place in health care,” said William Townley, New Mexico Center on Law and Poverty Healthcare Attorney. “Rolling back Section 1557 would allow discrimination and stereotyping to override patient care. This will endanger the health and lives of many New Mexicans and create needless confusion for providers and patients alike. We encourage individuals and groups to submit public comments with the Federal Register voicing opposition to the rollback of these important legal protections.”

“A patient’s health and wellbeing should always come first,” said Adrian N. Carver, Equality New Mexico Executive Director. “Giving healthcare professionals a license to discriminate against queer and transgender people is unacceptable. Rules that allow providers to ignore standard medical best practices and instead put their personal beliefs before patient health has the potential to gravely harm thousands of people and their families’ health. Our community must submit comment on these rules because, if enacted, these regulations threaten to completely upend the careful balance of religious freedom and other important human rights and instead grant providers a license to put their personal views before the healthcare needs of the patient.” 

The Trump administration is proposing rules that would reinterpret Section 1557 by

  • exempting a broad number of healthcare programs and entities from having to comply with Section 1557’s nondiscrimination provisions;
  • eliminating nondiscrimination protections for LGBTQ+ persons from regulations;
  • ending provisions that ensure people who speak languages other than English receive critical notices in the language they speak; 
  • removing protections against health plan designs that discriminate against people with serious or chronic health conditions.

“In addition to erasing the gender identity of individuals who identify outside of the binary choices of male or female, the proposed rule would gravely harm access to healthcare. The rule would let hospitals and clinics refuse to provide abortions based on religious or conscience concerns, even when there are no other providers in the area that could provide care,” said Terrelene Massey, Southwest Women’s Law Center Executive Director. “In a state such as New Mexico, which is largely rural, people do not always have a choice for where to go. In Santa Fe County, for example, the main provider of healthcare services is Catholic affiliated. Finding a medical provider without religious or conscience concerns would require a person to travel great distances and likely pay additional costs for using a provider out of their insurance network. The proposed Section 1557 changes could result in great bodily harm or even death to some, simply because of where they happen to live.”

Individuals can submit comments on proposed changes to Section 1557 at: https://www.federalregister.gov/documents/2019/06/14/2019-11512/nondiscrimination-in-health-and-health-education-programs-or-activities

Action Alert: Stop the Trump administration from undermining healthcare rights law

The Trump administration is attempting to undermine enforcement of nondiscrimination protections under the Affordable Care Act. These efforts will especially harm trans people, the LGBTQ+ community, patients who speak languages other than English, and people who need access to abortion services.

The ACA’s landmark nondiscrimination provision, known as Section 1557 or the Health Care Rights Law, protects patients from discrimination based on of race, color, national origin, sex, age, and disability. 

We encourage individuals and groups to submit comments with the Federal Register opposing the rollback of these important legal protections. Comments are due August 13.

The Trump administration is proposing rules that would reinterpret Section 1557 by:

  • exempting a broad number of healthcare programs and entities from having to comply with Section 1557’s nondiscrimination provisions;
  • eliminating nondiscrimination protections for LGBTQ+ persons from regulations;
  • ending provisions that ensure people who speak languages other than English receive critical notices in the language they speak; 
  • removing protections against health plan designs that discriminate against people with serious or chronic health conditions. 

Discrimination has no place in healthcare. Rolling back section 1557 would allow discrimination and stereotyping to override patient care. This will endanger the health and lives of many New Mexicans and create needless confusion for providers and patients alike. 

To ensure your comment is accepted, please make sure your comment has at least one-third original text. You can submit your comment here:http://eqnm.org/save1557

*Your comment will submitted via Equality NM. EQNM, the New Mexico Center on Law and Poverty, and Southwest Women’s Law Center will have access to your comment and contact information.

Sample content for your public comment

  • Section 1557 of the Affordable Care Act prohibits discrimination on the basis of race, color, national origin, sex, age, and disability. This proposed rule attempts to change the administrative implementation of Section 1557 in a way that is contrary to the plain language of the law.
  • New Mexico has some of the highest rates of residents who identify as transgender in the country. In many parts of the state there are areas where only one hospital or health provider could result in less access to healthcare for transgender people. This would result in some traveling far distances to receive critical care, while others may simply not receive any medical care. It is important that nondiscrimination protections are in place for healthcare providers to ensure that patients can access the same care provided to all, no matter who they are. These protections are fundamental for LGBTQ+ patients to be able to access the care they need. 
  • In New Mexico, 29% of respondents experienced a problem last year with their insurance related to being transgender, such as being denied coverage for care related to gender transition or being denied coverage for routine care because they were transgender.
  • Sex discrimination in health care has a disproportionate impact on women of color, LGBTQ+ people and individuals living at the intersections of multiple identities—resulting in them paying more for healthcare, receiving improper diagnoses at higher rates, being provided less effective treatments and sometimes being denied care altogether. The inability to access needed healthcare services could further exacerbate health disparities.
  • Discrimination has no place in healthcare. The delivery of healthcare services in the United States should be premised upon the medical needs of the people, and should not be obstructed by the personal beliefs or ideologies of their healthcare providers.
  • Discrimination on the basis of national origin, which encompasses discrimination on the basis of language, creates unequal access to healthcare. Without meaningful access, millions of individuals will be excluded from programs and services they are legally entitled to, including hundreds of thousands here in New Mexico.

Memorial to expand home visiting services passed by Senate Public Affairs Committee

SANTA FE— A memorial establishing an advisory council to develop a plan for the statewide expansion of a Medicaid-financed home visiting system in New Mexico, will head to the Senate floor following a “do-pass” vote today in the Senate Public Affairs Committee. Home visiting programs provide support and critical assistance for families that range from health care to emotional and social supports at a crucial time in a child’s brain development. Senate Memorial 117, Medicaid Home Visiting Program Council, is sponsored by Senator Linda M. Lopez.

“Every child deserves the best start from birth. Nurturing our state’s youngest children is key to ensuring they grow up healthy and prepared to succeed in life,” said William Townley, attorney at the New Mexico Center on Law and Poverty. “We’re optimistic that the memorial will pass the Senate.”

If passed by the New Mexico Senate, SM 117 would convene a council of home visiting providers and heads of the Human Services Department, Children, Youth and Families Department, Department of Health, and the Children’s Cabinet to make recommendations for expanding home visiting across the state through Medicaid financing.

Research shows that home visiting helps establish a strong foundation for families so children can grow up healthier and parents can develop stronger parenting skills. Home visiting programs that currently exist in New Mexico provide a team of professionals to help families learn about healthcare, child development, and parenting skills. Other services can include screening mothers for postpartum depression, supporting breastfeeding, and connecting families to community activities.

Unfortunately, most New Mexican families do not have access to home visiting services. Most services are offered by private non-profits that cannot scale up to meet the large unmet need in the state.

“Offering education early in a child’s life is essential in helping families succeed,” said Townley. “It would be good for everyone in New Mexico if more families could access home visiting.”

City of Anthony stands behind ‘Medicaid Buy-in’ 

Board of Trustees moved by local support and statewide momentum 

ANTHONY– The City of Anthony’s Board of Trustees, after hearing testimony from NM Together for Healthcare family leaders who live in Anthony, passed a resolution on Monday in favor of continuing the state’s efforts to shape a healthcare solution that would open up Medicaid for any New Mexican to buy into — regardless of their current Medicaid eligibility.

“All New Mexican families should have health insurance that allows them economic security and good health,” said Vanessa Urbina, Anthony resident and Strong Families New Mexico healthcare advocate. “Unfortunately, many New Mexican families, including over 25,000 Doña Ana County residents, do not have health insurance. Medicaid has worked for my family and many others. We should build on Medicaid by opening it up for everyone.”

Medicaid is a trusted program that provides quality, affordable healthcare to over 100,000 people in Doña Ana County. A well-designed Medicaid Buy-in plan would allow Anthony residents — like those that don’t qualify for Medicaid because of income or citizenship status—to buy into healthcare coverage offered through Medicaid.

Having more New Mexicans covered would reduce uncompensated care costs that are shifted to doctors and hospitals and reduce medical debt among families trying to build financial security.

“For some years, my husband and I could not walk without pain in our hips and waist, but thanks to Medicaid, we received the treatment we needed,” said Ramona Urbina, another a long-time Anthony resident and Strong Families healthcare leader. “Today my husband can work and so can I. We can still pay our bills. Everyone should have the right of good healthcare that they can afford.”

New Mexican leaders like the Urbina family are part of the NM Together for Healthcare campaign, a movement of diverse families and organizations from across the state working to build support for a Medicaid Buy-in plan.

The campaign has been successful in building support among policy makers across the state, and similar resolutions have passed with unanimous support in the City of Sunland Park and Bernalillo and McKinley Counties. The New Mexico House and Senate also passed a Medicaid Buy-in memorial to study a buy-in option with bipartisan support during the 2018 legislative session.

“Medicaid has helped my family improve their quality of life. My father had been running his own business for 20 plus years, and I was able to finish my University Bachelor degree in Public Health because we’ve been able to manage our health, focus on our goals, and go to the hospital without going into debt,” said Vanessa Urbina. “But many families are not eligible for Medicaid due to immigration status, or they just don’t know they are eligible. We are fighting to make sure that every New Mexican family has the chance to be healthy and create opportunities for themselves.”

The City of Anthony’s Board of Trustees will include this resolution in their legislative requests for the upcoming 2019 session and share the resolution with state legislators.

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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 MexicoPartnership for Community ActionNew Mexico Center on Law and Poverty, and Health Action New Mexico. For information, visit http://nmtogether4health.org/ or email: nmtogether4healthcare@gmail.com.

Bernalillo County champions ‘Medicaid Buy-in’

County Commissioners moved by local and statewide support for innovative solution

BERNALILLO COUNTY–The Bernalillo County Board of Commissioners, after hearing from NM Together for Healthcare leaders from Bernalillo County, passed a resolution today that supports the state’s commitment to exploring an innovative proposal to allow New Mexicans to purchase health insurance coverage through Medicaid — including to those who do not currently qualify for Medicaid or cannot afford to use their current insurance.

“The Medicaid Buy-in plan is important because insurance is very expensive, and all New Mexicans need healthcare coverage,” said Reyna Tovar, a Partnership for Community Action healthcare advocate and Bernalillo County resident. “When my husband was unemployed, we did not have health insurance. When he found a new job, he had to wait six months until he qualified for health insurance through his employer. We did not have coverage during this time because we made too much for Medicaid and Obamacare was too expensive to use.”

Since July, policymakers and community members have been working together to develop this affordable healthcare solution through statewide roundtables and the passing of similar resolutions through local governments like the City of Sunland Park, Doña Ana, and McKinley County. During the 2018 legislative session, Medicaid Buy-in memorials passed with bipartisan support in the New Mexico House and Senate.

Medicaid already covers over 850,000 New Mexicans, including over 228,065 Bernalillo County residents. The plan would expand Medicaid for all New Mexican’s to buy into, providing low-cost coverage for the over 54,000 Bernalillo County residents who are still uninsured. It would also provide affordable health insurance to individuals who are not eligible for Medicaid due to income, immigration status, and for those who have healthcare coverage but cannot afford to use it.

“A Buy-in program would build upon Medicaid’s strong foundation to ensure that families do not have to choose between death and financial ruin,” said Lan Sena, a resident of Bernalillo County and a Strong Families New Mexico healthcare advocate. “My grandfather, an immigrant, could not get Medicaid when he had cancer and died because he could not afford treatment. I have cancer too, and even though I have insurance, I still cannot afford my treatments.”

“I have to choose whether to pay for healthcare insurance or gas for my car,” said Tovar. “Many people don’t qualify for Medicaid or earn slightly too much for Medicaid and cannot afford to pay for healthcare on their own.”

Bernalillo County will share the resolution with state legislators and include this resolution in their legislative requests for the upcoming 2019 session.

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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, Partnership for Community Action, New Mexico Center on Law and Poverty, and Health Action New Mexico. For information, visit http://nmtogether4health.org/ or email: nmtogether4healthcare@gmail.com.

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

 

 

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.