ALBUQUERQUE, N.M. (AP) — State officials say keeping costs down while improving the delivery of health care for New Mexico's poorest residents is the focus as they propose changes to the Medicaid program to ensure sustainability as enrollment grows.
More than a quarter-million state residents have enrolled since the program's expansion in 2014. Now, more than 40 percent of children, the disabled and other low-income adults in New Mexico are covered.
State Human Services Secretary Brent Earnest said during a recent interview that despite the steady increase in enrollment, New Mexico has maintained benefits by cutting costs and coordinating care following a major overhaul of the system that was launched in 2014.
Those efforts will continue under a new waiver being sought from the federal government.
The current waiver expires at the end of next year, and the Human Services Department has been working on refining the program in light of persistent need in the poverty-stricken state and dwindling state and federal funding.
While much of the proposal builds on the changes already made by the state, officials are considering imposing some premiums for higher-income individuals and families living above the federal poverty level.
Earnest said having the flexibility to realign benefits for adults will stretch funding to maintain coverage for those who need it most.
"We've had significant enrollment growth, which means we have more people in the program and a higher budget, but on a per-person basis we're reducing costs in this program without having to do other major cost cutting, major changes to benefits or other things," Ernest said. "That has been the goal."
Advocacy groups including the Center on Law and Poverty are concerned about any changes in eligibility or the potential for higher premiums and co-pays, saying taking such steps could leave thousands of people without coverage.
Sireesha Manne, an attorney with the Albuquerque-based center, acknowledged that the federal government is picking up less of the tab for Medicaid and the burden is shifting to the states. In New Mexico, that burden has become painful as elected officials were forced to suspend construction projects and sweep various accounts to balance the budget for the next fiscal year.
Republican Gov. Susana Martinez has been calling for an overhaul of the state's tax system in hopes of boosting revenues to fill a void left by a downturn in the oil and natural gas sectors. Tax reform is sure to be on the agenda for the next legislative session in January.
"The key is to make sure the revenue proposals are fair to our families and that they raise the funds needed," Manne said. "The alternative is we are going to do extensive damage to our health care system and to our families in the long run and we don't want to see that either."
Manne and others say the focus needs to be on improving access to care and making the system more efficient.
Opposition to higher premiums and any changes to benefits are expected to be voiced during public meetings scheduled around the state this month.
State officials expect to have a draft waiver in September and another round of hearings will follow before the final application is submitted to federal officials.