COMMENTARY: Late Tuesday night, the Health Security Plan Analysis Act (House Bill 575) passed the House on a vote of 37-27. The 36 Democrats and one Republican who voted for this bill were making a strong statement. (There was even applause among supporting legislators after the vote result was announced – a very unusual demonstration of enthusiasm.)
It was clear that, given what is happening in Congress in regard to health care, the majority of state House members knew that New Mexico had to take the reins and develop its own plan. This was the opportune time for the very popular, homegrown Health Security Plan to finally be acknowledged as a serious alternative to an increasingly worrisome situation.
The Health Security Plan, as described in the Health Security Act, would enable New Mexico to set up a system that no longer relies on private insurance. Almost all New Mexicans would be automatically included in this plan – no more need to shop around for different policies with different deductibles, services and premiums.
Those few groups that would not be covered under the Health Security Plan, such as active-duty and retired military personnel, would continue with their current policies, meaning that everyone in the state would have health care coverage. Private insurance would continue to have a role as supplemental coverage for those who wish to purchase it.
Administered like a publicly accountable co-op, with a geographically representative citizens board, the plan would offer comprehensive coverage – no less than what is currently offered to state employees. Plan members could go to any health care provider or facility they chose to, even across state lines, and would not be limited to a narrow network.
The full Health Security Act – House Bill 101 – describes in great detail how the plan would be developed and implemented once a fiscal analysis has been conducted demonstrating the economic viability of this approach. Fiscal analysis first, then implementation: This was a requirement in prior versions of the Health Security Act as well.
This legislation has the support of 150 diverse organizations and thousands of New Mexicans. Who could oppose it? Not surprisingly, the insurance industry, the Association of Commerce and Industry and the New Mexico Hospital Association have consistently fought against it for years. This year was no exception – except the political environment had changed. Due to the growing concerns of New Mexicans about what is going on in Washington, the scales tipped heavily in favor of Health Security.
During the 2017 legislative session, House Bill 101, the Health Security Act, was introduced by Reps. Debbie Armstrong, D-Albuquerque, and Bobby Gonzales, D-Taos. The bill easily passed the two committees it was assigned to. Those in favor packed the hearing rooms. Hundreds of calls were made to legislators. For the first time ever, the Health Security Act made it to the floor of the House.
The opposition, however, did not stop trying to kill the bill. After listening to a common theme of concerns expressed by a few legislators, the bill sponsors ultimately decided that the best path forward was to uncouple the fiscal analysis from the actual implementation of the Health Security Plan. With House Bill 101 pulled back from the House floor into House Appropriations, the Health Security Plan Analysis Act was born. This shorter version would actually accomplish the same initial purpose as House Bill 101. House Bill 575 quickly headed to the House floor for its successful final passage.
House Bill 575 authorizes a fiscal analysis of the Health Security Plan, along with other models (like the current disastrous “repeal and replace” American Health Care Act being proposed by Congress). The Legislative Finance Committee would oversee the analysis, which is expected to be paid for through private foundation funding. The analysis itself will likely be conducted by a team of New Mexico university experts. A final report will be submitted to relevant interim committees by October 2018, in advance of the 2019 legislative session.
Armed with the information provided in the report, the legislature will need to decide whether the Health Security Plan should begin its implementation phase. Public support will clearly be critical at that time.
Even though House Bill 575 only focused on a fiscal analysis, the insurance industry continued to express its strong opposition. Why? Because it knows that the Health Security Plan is, indeed, financially feasible, especially for a state with a small population. Simplifying what is a complex and costly private insurance system – with hundreds of different policies, copays and deductibles – would reduce overhead costs for providers. Businesses would also likely see lower workers compensation and automobile insurance premiums, as the Health Security Plan would cover the medical components of these policies.
Two independent studies – one conducted in 1994 and the other in 2007 – both concluded that setting up an insurance plan that covers all or most New Mexicans would save the state hundreds of millions of dollars within five years. So, no wonder the insurance industry is concerned about a fiscal analysis!
Ten years after the last study, the Health Security Plan is more likely than ever the solution New Mexico has been waiting for. House Bill 575 puts the state in a position to move forward with a well-vetted plan and not just sit on its hands waiting for a disaster created by those who cling to the belief that a private insurance system is the best way to deal with the health care challenges we face.
The bill is now in the Senate. It has been assigned to one committee – Finance. Time is short, but it is still possible for our Legislature to declare that it is willing to take control of New Mexico’s health care destiny.
Mary Feldblum is executive director of the Health Security for New Mexicans Campaign. A former academic, her Ph.D. is in sociology. She has been involved in health care reform issues since 1993. She lives in Corrales.