University of New Mexico Hospital is the state’s largest public hospital and most important safety net. As such, UNMH is entrusted with significant local tax revenue each year to meet health care needs that no one else will meet.
In May 2017, hospital administrators implemented a policy that essentially denies medically necessary surgery to uninsured low-income residents of Bernalillo County by requiring them to pay 50 percent of the cost of surgery up front before the operation can be scheduled. If a surgery is medically “urgent,” patients must appeal to the Chief Medical Officer in order to receive care. It is unclear how patients would know this new appeals process exists or that it represents such a drastic change from the previous policy.
This new requirement is in direct conflict with UNMH payment policies established in 2009 and updated in October 2015, which call for a reasonable down payment of $25 for patients in poverty and allows for people to make payment plans to pay off the balance after surgery.
The new 50 percent up front policy singles out surgery patients who have already gone through the UNMH financial screening process, have proven that their income is low, and who cannot qualify for any assistance. They are not asking for free care – only the opportunity to get necessary health care first and worry about paying for it afterward, when they can work again.
This policy was created without input from or knowledge of the UNM Hospital Board of Trustees, the hospital’s medical providers, or the public. UNM Hospital quietly initiated this new policy while in the middle of prolonged, closed-door negotiations with Bernalillo County, UNM Board of Regents and the Indian Health Service about how $96 million in property taxes that voters approved in November should be used.
The draft contract among these parties addresses UNMH’s long-established responsibility for providing necessary health care to Bernalillo County indigents and to Native Americans residing in New Mexico in exchange for taxpayer support and no-cost leases for county and native land.