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Medicaid could open to paying customers

SANTA FE – New Mexico would open its Medicaid program to paying customers in an effort to expand affordable health care options under proposed legislation unveiled Wednesday.

The measure from Democratic Rep. Deborah Armstrong of Albuquerque aims to create a Medicaid buy-in option for state residents who make too much to qualify for Medicaid coverage or marketplace subsidies under the Affordable Care Act but still may struggle to afford adequate care. Medicare recipients would not be eligible.

The concept was embraced by Democratic Gov. Michelle Lujan Grisham on the campaign trail last year, and her budget recommendation for the coming fiscal year includes some initial funding.

Under the proposal, state residents would pay a monthly premium to the state in return for medical insurance under the state’s Medicaid program, which currently serves low-income families and individuals.

The measure calls on the state Human Services Department to create the program by 2021, building on the agency’s experience contracting with managed care organizations to provide Medicaid services.

The number of uninsured residents in New Mexico has been cut in half since former Gov. Susana Martinez expanded the state’s Medicaid program. As enrollment has stabilized, 9 percent of the state population remains uninsured.

“Medicaid buy-in is a simple idea, with a lot of potential for helping the New Mexicans who – for a variety of reasons – are struggling the most to get covered,” Armstrong said in a statement.

In states across the country, Democratic politicians are pressing to make good on campaign pledges to expand access to health care and push back against steps taken by the Trump administration and congressional Republicans to undermine the Affordable Care Act.

The Trump administration is pushing forward with short-term, limited-duration insurance and association health plans as an alternative to comprehensive but more costly policies under the Affordable Care Act.

A separate bill from Rep. Micaela Lara Cadena, D-Mesilla, would set minimum standards for those cheaper but skimpier plans, including provisions for coverage of pre-existing conditions.

The introduction of the Medicaid buy-in bill was applauded by U.S. Rep. Ben Ray Luján, D-N.M. on Wednesday in a news release.

The state bill also seeks $12 million for an investment fund aimed at ensuring the affordability of the Medicaid buy-in program.

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