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Wednesday, November 04, 2009
Governor, It's Time To Clarify If Budget Cuts Medicaid or Not
By Kim Posich
Executive Director, New Mexico Center on Law and Poverty
According to legislators, the budget they passed in special session makes no cuts to Medicaid. But according to the governor, as cited in a recent Journal story, the budget calls for “dramatically reduced critical services, such as Medicaid…” What gives?
According to the governor's office, the problem is in the language of the budget bill, and the stakes are high. One in four New Mexicans receive health care coverage through Medicaid, and they are mostly children and people with disabilities. In some counties, up to 40 percent of the population is covered by Medicaid. With a matching rate that brings four federal dollars into the economy for every $1 spent by the state, the program brings more than $2.5 billion into New Mexico every year. That money gets spent in every county in the state, shoring up our health care system and generating an estimated $3.36 billion in economic activity and more than 43,600 jobs.
For these reasons, the Legislature recognized that cuts to Medicaid in a time of recession will hurt New Mexico like cuts to no other program would. House Bill 17, the primary bill they passed to address the budget deficit, specified that Medicaid be spared any funding cuts. Some of the governor's staff, however, assert that the language in House Bill 17 only exempts a narrow portion of Medicaid from cuts, leaving the program vulnerable to deep reductions in funding.
Reasonable people can disagree on the interpretation of language. And it could be argued that the language in House Bill 17 is not precise. But when the language of a bill is ambiguous or subject to different interpretations, the longtime practice is to look for legislative intent to determine the meaning.
In this instance, the legislative intent is abundantly clear.
First, the bill excludes the “medical assistance program” from executive agency cuts. This is the same language used in federal statutes to refer to the entire Medicaid program of a state. Second, the discussion and debates that took place in the Round House indicate that legislators who voted on the bill thought the exemption applied to the entire Medicaid program. Third, the official analysis of the bill, prepared by the Legislative Finance Committee, clarified that all of Medicaid is to be excluded from cuts. Finally, the math in the bill — concerning the calculations of cuts to be made to other agencies and programs — makes sense only if no cuts were intended for Medicaid.
Every indication is that the bill holds Medicaid harmless.
Unfortunately, the disparity between the Legislature's intention and the interpretation of the bill's language by gubernatorial staff could lead to a long and costly battle. This would be a great disservice to the people of New Mexico.
The governor could do the right thing — protect Medicaid by implementing the budget as the Legislature intended with, of course, any line item vetoes he affects. If he thinks it necessary, he could ask legislative leadership for a formal statement of intent. And the Legislature could always clarify the bill language during the regular session if this, too, was deemed necessary.
Such a reasonable approach would put good practice in front of politics at a time when New Mexico most needs it. It would put the fiscal year 2010 deficit to rest. It would set the stage for reasonableness in the upcoming regular session in January, when additional difficult budget matters must be addressed. And it would be a clear message to the 500,000 New Mexicans who have been waiting to hear whether their health care program is being cut, to the tens of thousands of people who rely on Medicaid spending for their jobs, to health care providers around the state, that our state government is doing what's best for New Mexico.
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