I am writing today to announce the closure of the New Mexico Independent. After three and a half years of operation in New Mexico, the board of the American Independent News Network, has decided to shift publication of its news…
Federal dollars won’t stretch far on first health care reform
New Mexico likely will cap the number of New Mexicans who can join a new federal program for hard-to-insure individuals.
Only 1,000 to 1,500 New Mexicans could enroll in a federal high-risk pool, which starts July 1 and is the first reform to hit New Mexico from the new health care law.
State officials made the estimate Wednesday during a marathon meeting of a legislative panel charged with anticipating changes from the federal health care law.
The federal high-risk pool has provoked a slew of questions, including how can a small pot of money from Washington fund the program through Jan. 1, 2014, when most of the new law’s reforms kick in.
Under the new health care law, New Mexico will get $37 million over three years to fund the program, which is open only to individuals uninsured for six months.
But $37 million – or a little over $12 million a year – isn’t a lot of money for a pool that serves individuals that can’t get insurance in the private-sector either because of preexisting conditions or serious illness, officials said.
“That’s not going to put a big dent into the number of uninsured in New Mexico,” said Deborah Armstrong, director of the state’s high-risk pool – the New Mexico Medical Insurance Pool.
Varying estimates classify anywhere from 5,000 to 50,000 of New Mexico’s uninsured as hard to insure because they have preexisting conditions or are critically ill, Armstrong said. That would mean many of those individuals couldn’t join the federal high risk pool, but they could enroll in the state’s high risk pool only after waiting six months if they have a preexisting condition.
All one has to do to get a sense of how far $37 million will go in a high risk pool is look at New Mexico’s own program.
More than 7,800 New Mexicans were in the state’s high-risk pool at the end of 2009. Like the soon-to-be-created federal high-risk pool, the state’s program is a last-resort shelter for the participants who aren’t insurable in the private insurance markets. As a result the state’s high-risk pool paid out $88 million in medical and pharmacy claims in 2009, compared to the $19.8 million it took in premiums.
Those eye-popping numbers already have state officials trying to think creatively on how to make the federal money stretch as far as possible. The federal high risk pool is a bridge to 2014, when the new health care law will create state-run exchanges that supporters say will address the challenges hard-to-insure individuals face in getting insurance.
“How can we maximize this money to cover as many people as we can over the 3 ½ years in a fiscal manner,” Ruby Ann Esquibel, who will oversee the new federal high risk pool in New Mexico, told members of the panel Wednesday.
But the amount of money coming from Washington raised a flag for some state lawmakers on the panel, including one in particular who worried that New Mexico would have to step in to subsidize the federal high risk pool.
“I’m not sure under what rock we’ll find those” dollars, House Minority Leader Keith Gardner, R-Roswell, told other members of the working group.
Already New Mexico relies on federal grant money to help subsidize premiums paid by roughly 3,500 New Mexicans enrolled in the state’s high risk pool. As a result those individuals get 25 percent to 75 percent discounts on their premium amounts.
Gardner worried that the state might dip into some of that federal grant money to help subsidize premiums in the federal high risk pool.
The working group broke up Wednesday with a lot of questions unanswered. But ultimately the state will figure out how to stretch the money, Armstrong said.
“Then it’ll be incumbent upon all of us to advocate for more money,” she added, referring to the act of getting in touch with the state’s congressional representatives to press for more money.