In January, lawmakers in New Mexico proposed a new insurance option for uninsured residents, a Medicaid buy-in plan that would include undocumented immigrants and those who don't qualify for Medicaid, subsidies or have other coverage. However, the proposal has lost momentum due to the state’s finances and lack of federal funding for the Medicaid buy-in plan.|
Due to the demographics of New Mexico and the high level of uninsured, many believed that the state would certainly pass the Medicaid buy-in legislation. The New Mexico legislative session ends on Saturday and the bill has yet to pass a single committee. The bill as introduced, NM HB416 (19R) and NM SB405 (19R), would require $24 million in new state funding. This would just be the funding of the foundation with the state hoping to receive large amounts in federal subsidies through waivers that would have to be approved by the Trump Administration. When the bill was introduced, sponsors believed they would be able to put the plan in place by April 2020 – a lofty goal considering the state’s bumpy history with the early attempts at setting up a state exchange.
At this point, many believe the cost, and not necessarily the ideology behind the plan, will be what will prevent the legislation from passing. Reports were released that the program could cost between $27 and $80 million dollars annually – a large variance for budgeting purposes. For that price tag, 10,000-29,000 New Mexicans were expected to enroll, although according to the same reports about 80,000 residents would have qualified for the new Medicaid buy-in program.
The plan also did not have the full backing of Governor Grisham’s administration. They believed the bill needed to provide more regulatory authority to the state Department of Human Services; however, members of the department recognized that they are in the early months of the administration and would not want to rush in to establishing such an expansive program without taking the appropriate amount of time to research the cost to the state, the different types of federal funding that could be available, and how to best support the uninsured in their state.
The initial legislation has been amended to require the department to put together a study on how the program may be implemented, with a focus on federal funding. The revised legislation also changes language about the Medicaid reimbursement rates, which were criticized for being too low. The language now calls for “sufficient” payment to be made, but no further specifics on reimbursement. The cost of the planning phase in the governor’s budget request is $2 million.
New Mexico isn’t the only state interested in studying Medicaid buy-in options. Other legislation has been introduced in Colorado, Connecticut, New Hampshire, Nevada and Missouri.
After much anticipation that a Medicaid buy-in program could pass in New Mexico, it appears that the legislature will adjourn without a plan in place. Supporters of a Medicaid buy-in in New Mexico are still optimistic, hoping for a Medicaid buy-in plan to be implemented closely following the 2020 elections. As Rep. Christine Trujillo told her colleagues in an attempt to encourage their support of the program to assist the thousands of New Mexicans that cannot afford health insurance but also don’t qualify for subsidies, “I think this is great start. This is simply a study and we need to move this forward to do the right thing because life shouldn’t just be a big pile of poop.”