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.

Medicaid a Bright Spot in a Dismal Economy

Republished with permission by the New Mexico Political Report. To see the original article, follow: http://nmpoliticalreport.com/20757/medicaid-a-bright-spot-in-a-dismal-economy/

Abuko-2015-09-23By Abuko Estrada, Healthcare Staff Attorney at the New Mexico Center on Law and Poverty.

Since 2008, it has been gloomy in New Mexico. Our state is still recovering from the Great Recession. Our job growth has been among the worst in the nation, leaving us well short of pre-recession job levels. We are the only state in the nation where more people are moving out than moving in.

Our economic forecast still looks dismal.

There has, however, been one ray of sunshine–our healthcare sector is growing and over two hundred thousand New Mexicans have financial relief due to Medicaid expansion.

Now that we finally see a bright spot, let’s not ruin a good thing.

When New Mexico expanded Medicaid in 2014, our state had many reasons to celebrate. Polls showed overwhelming public support for Medicaid, with most voters in favor of Medicaid expansion and opposed to making cuts to the program.

The skyrocketing uninsured rate was taking its toll, leaving people without treatment or forcing families into medical debt and even bankruptcy. Medicaid expansion has meant that over 220,000 more New Mexican adults have health care coverage. This expansion of adult coverage also helped capture more uninsured children, reducing that rate by almost 16 percent during the first year alone.

New Mexicans knew that Medicaid expansion would boost job growth. In fact, the health care industry is driving job growth for our state. According to the Legislative Council Service, health care jobs have accounted for 56 percent of the new jobs over the last year.

We knew that Medicaid expansion would reduce costs for hospitals and healthcare providers, allowing them to invest in new facilities and their workforce. New Mexico’s 28 hospitals have already seen a 30 percent drop in the uncompensated care of uninsured patients from 2014. Our federally-qualified health centers, which have generally operated under budget deficits due to uncompensated care, had net income of $1.8 million dollars in fiscal year 2014. According to the New Mexico Primary Care Association, the better financial picture will allow the health centers to raise provider pay and increase capacity around the state.

We knew that Medicaid expansion would lead to economic relief for our families. In the past, people were routinely sent to collections for medical bills they could not pay. Healthcare coverage through Medicaid gives families more disposable income and the ability to build assets rather than struggle with debt. Every taxpayer also paid for state and county funds for hospitals to treat uninsured patients.

Finally, we knew that Medicaid expansion would be good for state revenue by injecting over $1 billion non-state dollars into the economy each year, primarily into the private sector, and increasing insurance taxes. In fiscal year 2014, The Department of Finance and Administration says New Mexico collected $115 million in insurance taxes. Economists with the Legislative Finance Committee estimate that number will grow to $247 million dollars by 2020.

For the first three years of expansion, we got all of these benefits at no cost to the state. In 2017, we will only pay 5 cents on the dollar, while the federal government takes on 95 percent of costs. After 2020, we will pay no more than one dime for every dollar to maintain these benefits. The insurance tax on Medicaid managed care companies retrieves 4 of these cents – canceling out nearly all of the State’s costs in upcoming years.

Still, some policymakers question the value of expansion and would like to cut support for the program.

It would be wrong to reverse course now and dump one of New Mexico’s best investments. Our state could lose hundreds of millions, if not billions, of dollars in economic activity.

Every dollar lost would damage our health care industry and workforce, stunting the driving sector for our job growth. Halting this growth could prove disastrous for our rural areas, which already face provider shortages. It would become more difficult to attract providers and build capacity.

New Mexico can only move forward if we capitalize on what we have. When the weather is finally breaking, let’s not take it for granted. By making the right choice to fully fund and support Medicaid, we can invest in a brighter future.