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.

Editorial: Shortchanging the Poor

Republished from the Las Vegas Optic. See the original column here.

Tuesday, July 19, 2016 at 6:30 pm (Updated: July 19, 6:42 pm)

U.S. Magistrate Judge Carmen Garza has concluded that the New Mexico Human Services Department should have someone looking over its shoulder to help ensure that it complies with court orders and federal law in the administration of federally funded benefits.

According to The Associated Press, Garza is also recommending a contempt finding against the agency, which oversees the distribution of federal food aid and Medicaid health care benefits to the poor.

To be sure, those are merely proposals at this point; the department has 14 days to file its objections, and the department is already saying that it doesn’t agree with everything in the judge’s decision.

Still, it’s unfortunate — though not surprising — that such extreme measures are necessary to get the department to follow the law and to finally comply with court orders that have gone unfulfilled.

The harsh measures being recommended are not surprising because of the striking testimony presented during the court proceedings in the case.

“Caseworkers’ sworn testimony that they were instructed by managers to fraudulently alter applicant information has essentially not been refuted,” Garza said. According to The Associated Press, Garza also noted that managers overseeing supplemental nutrition benefits invoked their Fifth Amendment right against self-incrimination during the proceedings.

The Human Services Department’s office of inspector general and the U.S. Department of Agriculture are investigating that part of the case.

We don’t doubt that the state Human Services Department has a difficult job with tight deadlines and large caseloads.

But it’s also important to remember that the agency exists to serve as a safety net for our state’s most vulnerable residents.

The aid this agency provides helps our state’s poor put food on the table for their families and get medical care for them. Playing games with that aid is unconscionable and wrong.

If it takes a special master looking over the agency’s shoulder to force it to do the right thing, then so be it.

According to The Associated Press, the special master would have expertise in determining eligibility for Medicaid and food aid. That individual would also be knowledgeable with the organizational and computer systems used to manage the state’s caseload.

The New Mexico Center on Law and Poverty, which brought forth the federal lawsuit on behalf of aid beneficiaries, was pleased with Garza’s decision, which was issued Monday.

“The things we have been asking for are very simple,” attorney Sovereign Hager told AP. “Train your workers on what the law requires, make sure the IT system does what it’s supposed to, make sure notices are intelligible and make sense.”

That seems reasonable to us.

Albuquerque Journal: NM high court hears case on workers’ comp for farm/ranch workers

Republished from the Albuquerque Journal. Click here to read the original article.

By Maggie Shepard / Journal Staff Writer
Thursday, April 28th, 2016 at 12:05am

On a small New Mexico dairy farm, an employee milking a cow does not have to be covered by workers’ compensation but the person’s supervisor, who might spend the workday in the same barn with the same animals, must be covered.

It’s a legal line that state Supreme Court justices hammered as they heard oral arguments Wednesday afternoon in a heated and possibly high-stakes case about a decades-old exemption in state law the allows farms and ranches with more than three employees to exempt laborers from workers’ compensation coverage.

A 2nd Judicial District Court judge and the Court of Appeals have ruled in one case that denying workers’ compensation to this type of farm and ranch worker is unconstitutional.

Dairy and ranch industry groups’ lawyers argued that forcing workers’ compensation coverage would cost farmers tens of millions of dollars, much of which they could not recoup from product sales, which usually are in markets that have government-set price controls.

When asked for the legal justification between the two groups of employees, like in the cow example, each of the industry lawyers arguing Wednesday struggled to find an answer that didn’t seem to anger the justices.

“It might save money by excluding certain workers, but is that a rational exclusion?” Chief Justice Charles Daniels asked the lead attorney representing the dairy and cattle industries.

Justices asked questions about how such an exemption could be considered constitutional.

Gail Evans, legal director for the New Mexico Center on Law and Poverty, argued that it is not and asked the justices to uphold a lower court’s ruling as such. She said those exempted are the “most vulnerable” employees.

She also asked that the justices make any unconstitutional judgment work retroactively.

But lawyers from the state’s Workers’ Compensation Administration and Uninsured Employer’s Fund argued that would open a flood gate of cases and a bureaucratic nightmare. They asked that if necessary, a ruling apply only to future claims to not only avoid a mess of back claims but also so that industry businesses can be fully aware of any new coverage requirement.

The coverage exemption also applies to household servants and real estate salespeople.

After more than two hours of arguments from five lawyers – oral arguments usually only last about one hour – before a packed and overflowing audience, justices took the case into consideration. It is not clear when they will make a decision.

Center files suit to block additional work requirements for SNAP recipients

SNAP LogoOn January 27, the Center filed suit against the New Mexico Human Services Department regarding the state’s imposition of additional work requirements for 17,500 struggling SNAP recipients.

The New Mexico Human Services Department recently implemented new SNAP eligibility requirements for childless adults ages 18 to 50. Effective on January 1, 2016, the new requirements limit individuals to just three months of SNAP assistance if they cannot find a job that offers 20 hours of work a week or a qualifying job training program, regardless of how hard they are looking for work or if applicable work training is even available. Read more about the importance of SNAP for New Mexico communities here. (link to Defeating Hunger project page).

The Center on Law and Poverty filed suit against the Department to oppose these requirements. Our complaint demonstrates how the state’s administration of the eligibility requirements and the harsh new time limit violate federal law. We are asking the federal court to enjoin the Human Services Department from proceeding with these requirements because they conflict with federal law, adults haven’t received proper notice about them, and workers haven’t been properly trained on the requirements.

You can read more about our lawsuit in the Albuquerque Journal and the Santa Fe New Mexican.