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Editorial: Medicaid Broke, Broken

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Last week, as the state announced a summer of public meetings on Medicaid and Gov. Susana Martinez joined 28 governors in outlining principles for its reform, legislators and health care advocates questioned whether there’s even a need for a fix.

They should have been asking whether New Mexico wants a sustainable safety net, or for poverty and health care coverage for low-income people to be our leading economic drivers.

The federal government set up Medicaid in 1965 as a safety net of health care services for low-income families and pregnant women, individuals with disabilities and others. Now, Medicaid serves one in four New Mexicans – more than 550,000. The state spends more than $600 million on it and is more generous than most, setting eligibility at 235 percent of the federal poverty level.

Kick in the federal government’s three-to-one match, and New Mexico Medicaid costs taxpayers about $4 billion a year. And just wait until the federal health care law takes effect in 2014. From 130,000 to 175,000 New Mexicans are expected to join the rolls.

That’s not a safety net; it’s a way of life.

On the quality-of-care side, last week The New York Times highlighted a study on Medicaid’s failure to offer enrolled children access to care. Researchers using a “secret shopper” technique found specialists in Cook County, Ill., turned away 66 percent of children with Medicaid compared with 11 percent with private insurance. Those who did get an appointment waited 22 days longer than other patients. The study’s findings, to be published in The New England Journal of Medicine, “match anecdotal reports from other parts of the country.”

That’s some if-it-ain’t-broke-don’t-fix-it program.

New Mexico Human Services Secretary Sidonie Squier says Medicaid “is in jeopardy. If we want to maintain the program for the future, we have to make changes now.” Changes that not only control spending but improve access to the care it pays for.

This editorial first appeared in the Albuquerque Journal. It was written by members of the editorial board and is unsigned as it represents the opinion of the newspaper rather than the writers.

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