NM, with eighth highest rate of drug overdose deaths, would face $13 billion federal Medicaid cut

April 11, 2017

Contact: Sharon Kayne, Communications Director, NM Voices for Children, 505-244-9505 

ALBUQUERQUE, NM – New Mexico’s opioid crisis, already responsible for one of the highest incidents of drug-related deaths in the nation, could be further exacerbated under the U.S. House plan to repeal the Affordable Care Act (ACA). According to new estimates released today by the Washington, DC-based Center on Budget and Policy Priorities (CBPP), the House ACA repeal bill would cut New Mexico’s Medicaid funding by more than $13 billion over the next ten years, jeopardizing New Mexico’s ability to provide adequate coverage for substance use disorder (SUD) treatment to all eligible residents.

Despite the bill’s failure to reach the House floor for a vote, Republicans are reportedly continuing negotiations to try and revive it or may pursue other ways to severely cut and cap funding for the Medicaid program – a move that could disproportionately affect millions of people with SUDs.

The ACA’s expansion of Medicaid to low-income adults has allowed millions of people with SUDs to get health coverage and access to SUD treatment services, according to a comprehensive report last year from the U.S. Surgeon General. In addition, because the ACA deemed it an essential health benefit, millions of people who bought coverage in the individual and small-group markets, including those getting coverage through the health reform’s marketplaces, have also gained coverage for SUD treatment.

“With one of the highest rates of drug-related deaths in the country, the last thing New Mexico needs is to reduce access to life-saving treatment,” said James Jimenez, executive director of NM Voices for Children. “But the House Republican health bill would do just that.”

The House Republicans’ ACA repeal bill, the American Health Care Act, would have threatened the gains in coverage for SUD by effectively ending the Medicaid expansion and capping and cutting Medicaid funding, in addition to other provisions that would have weakened individual and small-group market coverage and affordability. The bill would have left 24 million more Americans uninsured and shifted hundreds of millions in costs to states, including those that have been hit disproportionately by the opioid epidemic.

Rather than cutting access to SUD treatment, policy-makers in Washington should take steps to build on the success of the ACA to increase insurance eligibility and coverage for people with SUDs, according to the CBPP’s report. These steps include:

Maintaining Medicaid’s current financing structure. As currently structured, Medicaid expands to meet need, which ensures that states receive federal support to meet increasing demand for health care services, including public health challenges such as opioid addiction. Radically restructuring Medicaid’s financing system by converting it to a block grant or enacting a per capita cap, as House Republicans proposed, would eliminate Medicaid’s automatic response to need, and shift costs to the states, likely forcing New Mexico to cut services, reduce eligibility, or institute cost-sharing, which reduces access to health care.

Keeping the essential health benefit requirements for plans in the individual and small-group markets to ensure that substance use treatment is covered. Before the 2008 Mental Health Parity and Addition Equity Act (MHPAEA) and the ACA, most health plans either did not include substance use treatment or tightly constrained what they covered and for how long, so enrollees rarely used the benefits. The ACA requires all health plans in the individual and small-group markets to provide a package of minimum federal standards, known as “essential health benefits” (EHBs), for the services that health plans must cover, including SUD services.

The CBPP’s report, “Building on ACA’s Success Would Help Millions with Substance Use Disorders,” is available here 


New Mexico Voices for Children is a nonpartisan, nonprofit organization advocating for policies to improve the health and well-being of New Mexico’s children, families and communities.
625 Silver Ave. SW, Suite 195, Albuquerque, NM 87102; 505-244-9505 (p); www.nmvoices.org