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Legislators assail proposed state Medicaid changes

Copyright © 2017 Albuquerque Journal

Democratic state lawmakers on Wednesday bluntly criticized a proposal that would impose co-pays and monthly premiums on more of the low-income New Mexicans who rely on Medicaid for their health care.

The proposal would also scale back some benefits.

On the same day that Republican Gov. Susana Martinez expressed misgivings about a Republican bill to repeal Obamacare, her administration characterized the state-level benefit changes as minor, with exemptions built in to soften the impact.

Brent Earnest, secretary of state Human Services Department, said the goal is to limit cost increases, provide incentives that promote quality over quantity in New Mexico’s health care system, and encourage personal responsibility.

The debate, meanwhile, unfolded as Republicans in the U.S. Senate prepare to consider another proposal that would repeal the Affordable Care Act – the health care law passed under President Barack Obama also known as Obamacare. Congressional action could shake up the health care landscape in New Mexico, where more than 40 percent of the population is covered by Medicaid.

The program paid for 72 percent of the births in the state in 2015, the highest rate in the nation.

State Rep. Liz Thomson, D-Albuquerque, said imposing new co-pays and premiums, however small, could discourage people from seeking care when they need it.

“Am I going to pay Medicaid? Or am I going to eat? Hard choice,” she said, describing the potential dilemma for some families. “… These are the poorest of the poor.”

Earnest responded that some participants in Medicaid already must come up with the money for co-pays and premiums. The department is just proposing to impose them on a few more people, and exemptions remain for Native Americans and others, he said.

“We’ve tried to strike a reasonable balance in this proposal,” Earnest said during a meeting of the legislative Health and Human Services Committee in Albuquerque on Wednesday.

Adults who became eligible for Medicaid under the 2014 expansion in New Mexico would face new co-pays of $5 for doctor visits, $50 for hospital stays and surgeries, and $2 for prescriptions, in some cases.

Household premiums could be up to $50 a month in 2019, though they could rise in future years. The amount depends on the household’s income level and other factors.

The proposal will be the subject of public hearings throughout New Mexico and submitted to the federal government for consideration later this year. If approved, it would go into effect Jan. 1, 2019.

Abuko Estrada, a staff attorney for the New Mexico Center on Law and Poverty, said the diminished benefits could lead to financial ruin for some families. The proposal would eliminate a provision that allows people to seek retroactive coverage if they sign up for Medicaid after receiving emergency care, he said.

“These cuts can’t be taken lightly,” Estrada said. “They reach to patients and reverberate throughout our entire health care system and the state economy.”

Earnest said the retroactive provision isn’t used as much now as it once was, given the Affordable Care Act’s mandate that everyone have insurance.

Democratic lawmakers didn’t sound persuaded.

The proposal “is cruel, and it’s cowardly,” said Rep. Miguel P. Garcia, D-Albuquerque.

Wednesday’s legislative questions, of course, come as the U.S. Senate is set to consider another push to repeal Obamacare and adopt a new health care law in its place.

New Mexico is among the states that opted, under Obamacare, to expand Medicaid to more people.

Gov. Martinez has largely stayed out of the debate in Congress over repealing Obamacare, but her spokesman voiced concern Wednesday over the latest bill.

“While it’s encouraging that Congress is working on a health care solution, the governor is concerned this bill could hurt New Mexico and still needs some work,” Martinez spokesman Joseph Cueto told the Journal.

Among other provisions, the bill written by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana would convert federal health insurance funding into block grants for states and do away with coverage mandates.

Meanwhile, Earnest said the various Republican-backed proposals have been difficult to keep up with and analyze.

But “under most of these proposals,” he said, “New Mexico loses.”

Journal Capitol Bureau chief Dan Boyd contributed to this report.

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