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.

Important Players Honored at the Center’s 20th Anniversary Celebration

As part of our joyful 20th Anniversary Celebration on April 14, 2016, we recognized some of the individuals who have played indispensable roles in the establishment and success of the Center.

The Center’s First Executive Director

thumb resized Bob EricsonBob Ericson, the first Executive Director the Center. Bob was a lifetime legal service attorney and is remembered as a meticulous, skilled, and compassionate attorney. His legal skills and leadership influenced the Center on Law and Poverty’s culture of excellent work, integrity, and service to low-income New Mexicans—values we still hold strong today. He touched the lives of so many people in New Mexico.

The Extraordinary Members of the Founding Board of Directors

thumb resized Ruth KovnatRuth Kovnat, Emerita Professor of Law at University of New Mexico School of Law. Ruth served as President of our Board of Directors. If you practice law in New Mexico, there’s a good chance you either learned from Ruth or learned from someone who learned from her. Ruth has been an ongoing supporter of the Center and equal access to justice for the poor.

THUMB resized Tim Sheehan 2010Timothy Sheehan, retired attorney from the firm of Sheehan and Sheehan, PA. Tim served as Secretary and Treasurer of our Board. He has worked extensively at state and national levels to promote and fund legal services for the poor.



thumb resized Bill StrouseBill Strouse, former Executive Director of Legal Aid in Southern New Mexico, the Community Action Agency of Southern New Mexico, and the statewide, consolidated New Mexico Legal Aid. He helped build each of those organizations substantially. Bill served as Vice President of the Center’s Board.

THUMB resized Virginia SearsVirginia Sears (1915-2001), legal services consultant with the New Mexico State Bar Association and Northern New Mexico Legal Services. Virginia was a wonderful lifelong senior advocate and activist.



thumb resized John RobbJohn Robb (1924-2014), partner at the firm of Rodey, Dickason, Sloan, Akin & Robb, PA. John, who was the first President of our Board of Directors, demonstrated a powerful commitment to civil legal aid for the poor. In addition to serving on the Center’s board for over a decade, he also participated on the boards of the National Legal Aid and Defender Association and the ABA’s Standing Committee on Legal Aid and Indigent Defendants. Click below to hear John’s thoughts about the NM Center on Law and Poverty.

A Few Key Staff Members

Nancy Koenigsberg, current Senior Attorney at Disability Rights New Mexico. Nancy led the Center as Legal Director and Acting Executive Director for five years. She made sure the Center maintained its commitment to excellent work and service following Bob Ericson’s passing.

Sireesha Manne, Staff Attorney. Sireesha has been a leader in the Center’s healthcare advocacy and critical to the Center’s success in policy work in the legislature and executive branch.

Gail Evans, Legal Director. Gail is widely regarded as one of the best poverty law attorneys in the country. Both the excellence of the Center’s advocacy and its enviable string of successes in the courts are testament to that. She has been a persistent, unflagging voice for low-income New Mexicans.

Stacey Leaman, Development Director. Stacey’s fundraising efforts have allowed the Center to add staff, diversify our campaigns, and make a broader impact.

Kim Posich, the Center’s Executive Director. Since becoming Executive Director in October 2002, Kim has expanded the Center’s size, resources, and advocacy agenda. Under his leadership, the Center went from a team of 3 to today being a staff of 15—including a remarkable 11 attorneys! This has corresponded with an expansion of the Center’s work. Kim has dedicated his entire life to working on behalf of those with fewer resources, less privilege, and greater need. He has tirelessly championed the poor, making an enormous and measurable difference for thousands of families in this state.