Waiting for judgment day

by Bill Jordan
September 10, 2012

The Supreme Court decision on ObamaCare has put the health care of 150,000 New Mexicans in the hands of Governor Martinez. When the Court struck down the penalty for not expanding Medicaid coverage for low-income adults, it essentially gave all 50 governors the ability to decide the fate of their states’ most vulnerable residents. To date, a handful of governors have said they will not expand Medicaid, while about a dozen have already opted in.

Governor Martinez initially said she was concerned about the cost to the state and therefore would study the issue before making a decision. Since then New Mexico Voices for Children, the Bureau of Business and Economic Research, and independent economists have all said the state’s cost of expansion would easily be covered by existing taxes on all those federal funds that ObamaCare will send to the state. It’s now clear that the governor cannot credibly oppose the expansion because of the cost.

More recently, the governor’s administration has said they have a series of “questions of great importance” that they are asking the federal government before making a decision. While we don’t know what those questions are, we remain concerned that the state may seek to weaken the coverage, narrow the eligibility, or otherwise shortchange our most vulnerable uninsured adults.

We’re hearing some of the reasons other governors are citing to deny care to their low-income adults, so let’s look at them and whether they are valid.

  • The state cost.

In New Mexico, cost is simply not an issue. Without raising any taxes, New Mexico will pull in enough new tax revenue to more than cover the state’s cost of the Medicaid expansion. In fact, in the first seven years, the revenue will be more than double what we need to pay the state’s share. In other words, New Mexico will make money from ObamaCare, and not have to worry about paying our share of the cost.

  • Medicaid is unpopular.

The opposite is true. Polls show that people on Medicaid rate their satisfaction higher than those with employer-provided private insurance. Studies have shown that Medicaid lowers mortality rates and improves patient outcomes.

  • Medicaid is government-run health care.

Medicaid is simply a source of payment. In New Mexico, health care under Medicaid is provided by all the major private managed care organizations. The administrative costs of Medicaid are extremely low and well below that of private insurance.  If you already have health insurance, the government will have little say in the delivery of care and will not come between you and your doctor. ObamaCare does, however, mandate a minimum benefit package and require that insurance companies spend 80 percent or more of your premiums on health care. ObamaCare also says insurance companies can no longer (in 2014) deny coverage, revoke your coverage when you get sick or enact lifetime limits on coverage.

  • Medicaid reimbursement rates.

New Mexico’s Medicaid payments to providers are some of the highest in the nation.  The state has been proactive in recruiting providers and paying an adequate reimbursement.  With an additional 150,000 New Mexicans added to Medicaid, the number of providers accepting Medicaid is likely to increase, not decrease.

We don’t know why Governor Martinez is still pondering the Medicaid expansion and we honestly can’t think of a good reason for her to deny health care to 150,000 of our friends, family, and neighbors. To those New Mexicans who don’t have health insurance because their employers don’t provide it and they can’t afford it on their own, this decision is literally a matter of life and death. But all of us will anxiously await—with hope—our Governor’s Judgment Day.

Bill Jordan is Policy Director for New Mexico Voices for Children.