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…
Posts Tagged Pam Hyde
A just-published survey of Medicaid directors in all 50 states shows that New Mexico officials aren’t alone in fretting about how to adequately fund the government’s low-income health insurance program. More …
The state’s unemployment rate rose to 7.5 percent in August, but that depressing figure could have some positive effects. The increase could unlock up to $10 million in additional federal stimulus funding for Medicaid in New Mexico. The new money, if it materializes, would come as the state faces a $40 million shortfall in funding for healthcare for the neediest New Mexicans.
Come January, New Mexico could face a $300 million shortfall in its low-income health insurance program, and state officials are scrambling to figure out how to address a potential ocean of red ink. The state already has tried many cost-cutting measures—the “low-hanging fruit,” officials call them—to slow the cost growth in Medicaid. But now, because of the severity of the situation, they’re eying many previously off-the-table scenarios.
States across the country are responding to a funding crisis in Medicaid, the government’s low-income health insurance program jointly paid for by the feds and state governments, Laura Tobler of the National Conference of State Legislatures, told New Mexico state lawmakers at an interim legislative committee meeting this week.
Tobler’s message to lawmakers was simple: You are not alone.
California cut provider payments. Florida reduced funding for nursing homes by 10.5 percent. Massachusetts reduced adult dental services for 600,000 recipients of its low-income health insurance program.
Some states are taking several tactics, from fighting against Medicaid fraud to making care for high-risk, high-cost patients more efficient.
New York, a state with a history of Medicaid fraud, recently modified its management information system to better identify improperly paid claims. At the same time that state has created pilot projects with a focus on treating chronically ill Medicaid beneficiaries.
South Carolina, meanwhile, decided to post Medicaid payment information online to try to guard against fraud. It has also reduced—from 34 to 31—the amount of pills in each monthly prescription for Medicaid enrollees.
Utah, which has already cut optional services, created a preferred drug list. Such lists show what prescription drugs are approved for payment. In many cases, the lists limit the drugs to a certain number of drugs in each category of treatment.
The cutting has begun
New Mexico has already begun to make cost-cutting measures, such as starting with capping the amount of money managed care organizations can spend on administrative costs, New Mexico’s Human Services Secretary Pam Hyde said Wednesday.
“The good news is that we’ve already done many of these things,” Hyde said of the cost-cutting steps. “The bad news is that we’ve done many of these things.”
In other words, state officials are now looking for more ways to trim spending, including eliminating many, if not all, optional Medicaid services.
The potentially extreme measure is part of the mix this year because mandatory Medicaid services — such as hospital stays and physician services — are projected to grow to $550 million in early 2011. That’s compared to a projected $340 million for optional services.
If the state cuts $300 million to close the shortfall, very little money would be left for services that aren’t mandatory.
Cutting some optional services is a path Utah already has started down, Tobler said. That state eliminated vision, physical and speech therapy and chiropractic services, all optional under Medicaid, according to her presentation.
Spending cuts vs. tax increases
This tough economic situation has thrust legislators into the center of a fierce debate over spending cuts vs. revenue-side solutions like tax increases to fix the problem. Meetings have been planned around the state to collect public input.
The implications of such deep cuts are potentially dire for New Mexico, where one in four residents—more than 500,000 individuals—gets health coverage in whole or part through some form of public assistance. Medicaid provides the lion’s share of that coverage with more than 450,000 enrollees, according to Hyde’s agency.
“Some of these short-term cuts will create long-term problems” for people who receive these services, said Rep. Eleanor Chavez, D-Albuquerque.
Meanwhile, critics of raising taxes say the last thing a government should do during a deep recession is take money out of taxpayers’ pockets.
“We have to get back to core spending,” said House Minority Whip Keith Gardner, R-Roswell.
For many states, Medicaid is one of the biggest line items in their budgets. The program helps to underwrite a spectrum of services, from nursing home care and medications to vision and physicians visits.
But not all patients contribute equally to the cost of the program. Four percent of the Medicaid population is responsible for 50 percent of Medicaid spending, according to the Kaiser Commission on Medicaid and the Uninsured.
At the meeting, Rep. Dennis Kintigh, R-Roswell, wondered how many of those patients had those illnesses because of substance abuse. He also asked how much “life choices” contributed to the chances of people winding up on Medicaid rolls.
There is no silver bullet
Cutting optional services isn’t the only cost-saving measure under consideration. Another is the dismantling New Mexico’s State Coverage Insurance (SCI) program.
SCI helps pay premiums for thousands of low-income individuals, and small businesses take advantage of the program to insure employees, officials said.
Another cost-cutting option–and one generally considered to be one of the easiest to accomplish–is to reduce the rate of reimbursement to medical providers, such as physicians and nurse practitioners. Medicaid reimburses medical providers at various rates.
But even that can lead to unintended consequences like a diminishment in health care access, Tobler said.
”There is documented evidence that that reimbursement rate reductions leads to reductions in provider participation,” Tobler said.
How New Mexico will respond to the Medicaid problem, either in a special session scheduled for October or in the regular 2010 session in January — is not clear. But one thing is, say officials and state lawmakers. There is no silver bullet, a one-shot approach that fills the budgetary gap without parceling out some pain.
More New Mexicans prefer spending cuts to tax increases to balance the state’s nearly $5.5 billion budget, according to the results of an Albuquerque Journal poll released today. But some advocates say they’d rather see the repeal of tax cuts than cuts to Medicaid. One in four New Mexicans gets health coverage in whole or part through some form of public assistance.
Thousands of low-income New Mexicans could lose medications, vision and dental services, hospice care and physical therapy because of a potential huge shortfall in Medicaid, Human Services Secretary Pam Hyde told state lawmakers Wednesday.
Signs are everywhere that the economic slump is affecting those who have the least resources.
A petite woman with a friendly face framed by curly black hair, Martinez was on hand Thursday to hear Gov. Bill Richardson and other officials announce that the federal government is purchasing $700,000 in extra food.
The chicken and pork products, along with canned fruit and produce, is being distributed over the next several months to low-income New Mexicans across the state who might otherwise go hungry.
Among those expected to benefit are senior citizens who rely on boxes of food supplied by Albuquerque’s Roadrunner Food Bank and children at 35 low-income schools. They receive backpacks during the school year packed with food for weekends and holidays.
“There are people out there living on $300 a month,” she said.
Martinez has a street-level perspective of hunger in New Mexico.
She coordinates deliveries of food to individuals and families living in Albuquerque’s Brentwood Gardens Apartments, where she is a resident. She volunteers at the food bank, but she also is a client, receiving a box of food each month meant to last her 30 or so days.
“I know how to budget,” Martinez says. “I learned from an early age. My mom always made us beans, tortillas with green chile. Others don’t know how to.”
Things have gotten worse in the last year, she said.
“People are hurting. If you are working and you’re hurting, you’re definitely hurting if you are on a fixed income,” Martinez said.
Melody Wattenbarger, executive director at the Roadrunner Food Bank, has noted the rise in hunger too. It’s hard to miss, she said.
A year ago the Roadrunner Food Bank was shipping 65,000 pounds of food a day to its partner food banks across the state. Today that amount is 90,000 pounds, Wattenbarger said.
The increase has to do with rising need, Wattenbarger acknowledged. But it also has to do with the additional food that is on hand thanks to the federal government’s cash infusion.
On Thursday, 552 whole chickens and 868 cases of applesauce were shipped out, headed to various parts of the state, thanks to the federal stimulus money.
But that’s only a small fraction of what the $700,000 pays for, state officials said.
“That’s nearly 600,000 pounds of food that will soon be on dinner tables around the state,” Richardson said of the federal infusion. “These are tough times. More and more New Mexicans are turning to some kind of assistance to help provide a decent meal for their families.”
The economic slump has led to a 28 percent increase in applicants for New Mexico’s food stamp program, said Pam Hyde, the New Mexico Human Services Department secretary.
“We are seeing a lot of people come in to our offices for the first time asking for help for food on the table,” Hyde added.
The money earmarked for New Mexico is part of a $100 million infusion of stimulus funds to the U.S. Department of Agriculture’s Emergency Assistance Food Program, Rosa Coronado, director of USDA’s Special Nutrition Program, said Thursday.
New Mexico, like other states, is receiving poultry, pork, canned fruits, peanut products and cheese.
The state also is receiving $173,000 to help agencies and organizations pay for the administrative costs required to handle the additional food, Coronado said.