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-- Coalition Has Health Plan Idea

By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer

Business opponents of Gov. Bill Richardson's health coverage plan have this advice for legislators attending the special session planned for this summer: Spread the pain around. Instead of taxing employers to create a healthy workforce fund, as originally proposed, consider a broad-based tax to expand existing coverage programs, said two members of a state business coalition that opposed universal healthcare coverage legislation the Richardson administration crafted.

"The main thing we were against was the expense was all on the backs of employers," said New Mexico Restaurant Association CEO Carol Wight. "We understand there needs to be employer participation, but all of us need to participate," said Association of Commerce and Industry President BeverleeMcClure.

"It may be if we find a way for all of us to participate through the gross receipts tax or other mechanism, you might find ACI would participate in looking at those options," McClure said.

Richardson announced in February, after what he called a "productive"meeting with state Senate leaders, that he will call a special session some time this summer to enact a program to bring health care coverage to New Mexico's 400,000 uninsured residents. In its regular 30-day session that ended Feb. 14, the Legislature first gutted then killed a Richardson plan that, among other things, would have taxed employers who didn't offer health insurance to workers. Richardson said at the end of the session that he would propose the identical bill in a special session. Thursday, he said legislators and members of his administration would look for consensus before the special session convenes. Aside from the burden on employers, Wight and McClure said, their groups are skeptical the original plan would have got that many more people insured. The bill said individuals had to find some coverage, but nothing in the bill, had it become law, would have forced anyone to get it, McClure said. She said that about half of the state's uninsured already qualify for some kind of coverage or public program, and they still don't sign up. Wight said her members have tried to get their employees to sign up for State Coverage Insurance, a low-cost, state-subsidized health insurance product that requires both employers and employees to pay some of the cost.

"They refuse it," she said. "They want to pay their cable bill. They want to pay their cell phone bill." A place to begin, McClure said, is improving recruitment of qualified peoplei nto existing public programs, especially Medicaid. Under the governor's plan, the employer tax would feed a fund that could have been used for pretty much anything, McClure said.

A better idea would be to create a fund dedicated to expanding existing public programs, she said.

Pegging coverage to employment won't work, Wight said. "I'm going to say over half of those (400,000) people are not employed," Wight said. "They're students, children and retirees, possibly, who don't fit into Medicare yet. If we're counting on employers to pick up that tab, we're approaching it incorrectly because so many of them are not employed. A better solution would be a broader tax and make it the responsibility of all New Mexicans."

The Greater Albuquerque Chamber of Commerce broke with other business organizations and supported Richardson's plan, saying that while the plan had its flaws, the cost of doing nothing was too great. The chamber took heat from some Republican lawmakers at committee hearings for supporting the bill, and the Greater Las Cruces Chamber of Commerce blasted its Albuquerque counterpart for "consistently" backing legislation "contrary to the interests of New Mexico businesses and in direct opposition to the welfare of small businesses in the state." In a letter it provided to the Journal, the Las Cruces chamber called the Albuquerque chamber's support of Richardson's bill "unfathomable." Referring to the chamber's board, the Las Cruces group said, "We do not believethat a small group of 18 individuals representing big business interests, heavily state regulated industries and a few of your chosen suppliers have the right to represent yourselves as the business community. We resent andrejectyour on-going claims that you make to the public and legislators thatyou arethe voice of business, especially small businesses which you clearly donotrepresent." Albuquerque chamber President Terri Cole said in an e-mail to theJournal thatbusiness pays for uncompensated health care already, through higherpremiums andtaxes, so providing universal coverage ultimately reduces costs tobusiness. "The bill represented a solution we support- universal coveragewithoutover-burdening those businesses who provide coverage and those who donot," Colesaid. "The bill provided an incentive for businesses that don't providecoverage toseek out existing, low-cost, under-utilized programs," she said. "Webelievethat approach was a win-win for everyone."

Medicaid Budget Short

By Winthrop Quigley
April 7, 2008 Albuquerque Journal; Journal Staff Writer

Weeks after asking legislators to provide health care coverage foreveryone, the Richardson administration is trying to overcome amultimillion-dollar Medicaidbudget deficit by slowing enrollment growth.The state legislative session that ended in February added $14.5 millionto the Medicaid budget to offset what the Human Services Department saidwould be a $24.5 million shortfall in the fiscal year that ends June 30,leaving a $10 million deficit. The Medicaid budget for the followingfiscal year is $25.8 million less than the department requested.State Medicaid officials will try to overcome the current fiscal year'sdeficit by slowing Medicaid enrollment from 299,000 children by June,which is the number of children the state could afford to cover hadlegislators approved the entire HSD requires, to 294,000. About 275,000low-income children and 143,000 low-income adults- most of them disabledor elderly- were enrolled in November 2007, the last month for which HSDhas complete data."In 2009, we have a much bigger problem," said state Medicaid directorCarolyn Ingram. "What we're looking at is trying to flatten outenrollmentgrowth of kids so it's not so steep."That's an about-face from the department's goal at the beginning of thefiscal year, when the state intended to enroll as many eligible childrenas possible. The belief was that getting children access to consistenthealth care reduces costs in the long term.Instead, efforts to reach families of Medicaid-eligible children to getthe kids enrolled will be curtailed.HSD will also slow growth in State Coverage Insurance, which targetslow-income adults.The department wants to reduce spending on personal in-home careprovidedto elderly and disabled Medicaid recipients. HSD will try to limit newMedicaid enrollment by disabled and elderly people to emergency cases.If that does not reduce spending enough, HSD will consider reducingpayments to medical providers, Ingram said. "That is not the mostfavoredoption," she said."We just spent two years increasing provider rates."

Finally, HSD will consider reducing Medicaid benefits. One potentialtarget is expenses incurred by a caregiver who accompanies a Medicaidrecipient whoreceives treatment out of state. Gov. Bill Richardson had asked the 2008 Legislature to enact severalprovisions designed to expand public programs to cover New Mexicanswho could not obtain private coverage. The governor's universal healthcoverage package failed. "It is clear from the funding of the Medicaid program that was notanarea (the Legislature) could put money toward at this time," Ingramsaid. "There were other priorities." One advocacy organization said the most vulnerable group is takingtheworst hit. "The bottom line here is that kids will suffer," said Bill Jordan,policy director of New Mexico Voices for Children. "Their health carewill be interrupted. Kids shouldn't be the ones caught in the middlewhen lawmakers cannot agree on a dollar amount." Much of the state Medicaid budget of more than $3 billion isprovidedby the federal government. However, the state general fund willprovide $711.2 million this fiscal year and $787.4 million next fiscalyear to support Medicaid. State officials have estimated that 50,000 children who are eligiblefor Medicaid are not enrolled. HSD has sponsored several efforts toincrease enrollment in the past several months. "We'll definitely be slowing our outreach initiatives," Ingram said.

"We won't be running television commercials. We won't be running radioads." Enrollment efforts instead will focus on finding eligiblechildren at small, low-income school districts, she said. HSD will continue to support efforts by insurance brokers to sellState Coverage Insurance to employers and their low-income employees,but state officials will stop promoting enrollment through speechesand other events.

Charlotte Roybal
Health Care for All Campaign
Health Action NM
roybalhanm@aol.comwww.healthactionnm.org
505-867-1095 (o)