Dede Feldman
Last year, as the Republicans and Democrats continued to battle over the Affordable Care Act on the national stage, New Mexicans were rolling up their sleeves and beginning to implement the new law here. A joint legislative and executive working group, with a diverse group of stakeholders from the business and insurance sector, as well as ordinary citizens, met for eight months to examine issues like Medicaid and insurance changes and make recommendations for a uniquely New Mexican health insurance exchange.
I hope our new governor will not turn her back on the opportunities this bill opens up for New Mexicans, and the jobs it has already created here in the state.
In only nine months, New Mexico has received nearly $90 million to support our high-risk pool (which allows people with preexisting conditions to obtain insurance), expand community health centers in rural and underserved areas, increase training for much needed nurses, doctors and other needed health care providers, among other things.
In a time of budget constraints, this funding has not required a state match, and the jobs created in clinics, universities and hospitals are a much-needed boost to rural communities where the health care sector is the prime economic mover.
Many other funds have flowed to the private sector to help employers pay for insurance for their employees. PNM, Intel, Sandia, UNM, LANL and the state’s own Retiree Health Program have benefitted from a program to help them pay for health benefits for their early retirees – and buck the trend of reduced benefits and increasing co-pays for this population, largely in their 50s.
As the state continues to plan for full implementation of the bill in 2014, we have benefitted from $3 million to plan for our own health insurance exchange (the feds will set one up for us if we don’t), synch state insurance law with new federal rules, and improve our system of reviewing insurance rate hikes. These planning funds will continue, with full funds already appropriated for the state to set up the exchange through 2015.
And there is more to come. Ultimately, New Mexico will gain $6 billion to $8 billion from the new law in the next decade, according to Sen. Bingaman’s office.
Unprecedented control
One overlooked feature of the new health care act is that it gives an unprecedented amount of control to the states to build on their own programs and fill in the gaps as they see fit. In New Mexico, for example, we have been able to build on an existing Medical Insurance Pool for high-risk patients.
And although we do not currently have a health insurance exchange (a more consumer-friendly marketplace where individuals and small employers can purchase policies more easily and cheaply), the idea has been repeatedly proposed by Republican legislators and supported by Democrats, gaining enough support in 2007 to pass the Senate.
This fall, the working group convened as a result of last year’s Senate Joint Memorial 1 proposed we establish a New Mexico exchange as a non-profit organization, outside of state government. This marketplace, which would be coordinated with the Medicaid program, would include small group as well as individual policies, and have the power to negotiate with insurance companies in a robust fashion. The group left open the door to join a regional exchange if that seems possible in the next three years that the federal government gives the states to have their exchanges ready to go.
This legislative session there will be several bills introduced to further this recommendation. The governor should support the idea.
Benefits keep trickling in
Meanwhile, despite the much-ballyhooed efforts in Washington and Virginia to repeal the Affordable Care Act, the benefits of the health care bill just keep on trickling into New Mexico. Just this month, seniors on Medicare became eligible for a free annual check-up and will no longer be required to pay co-pays on preventive screenings for cancer and diabetes. Last year, about 15,000 seniors got a $250 rebate if they fell short on paying for prescription drugs, and starting this year they can get a 50 percent discount on brand-name drugs if they fall into the donut hole, a coverage gap created by the prescription drug bill several years ago.
On this year’s tax forms, small businesses with fewer than 25 employees can file for tax credits for up to $35,000 if they cover employees who earn less than $50,000 a year. According to the IRS, over 25,000 small businesses in the state are eligible.
Finally, the state’s department of insurance is implementing a new requirement that health insurance companies pay more of the health care premiums they receive on actual care, and not on profits and administration. If they don’t comply, consumers will get a rebate.
Whatever your views about the Affordable Care Act, it just doesn’t make sense to turn back now – not when so much money is on the table, there to build our health-care workforce, help our small businesses and provide more accessible, affordable care to thousands of New Mexicans who are currently struggling to keep their heads above water.
Feldman, a Democrat, represents N.M. Senate District 13. She was the sponsor of SJM1, which created the Health Care Reform working group, and is the chair of the Senate Public Affairs Committee.