Commentary: Today, U.S. Senator Tom Udall addressed a joint session of the New Mexico legislature. In his speech, Udall discussed the impact that repealing the Affordable Care Act (ACA) could have on New Mexico’s already fragile economy and state budget. He highlighted the stories of New Mexicans who are relying on the life-saving, historic protections of the ACA, and who stand to lose health and economic security if Republicans are successful in repealing the law without any replacement. In addition, Udall spoke out on behalf of immigrant rights and against President Trump’s unconstitutional, anti-Muslim and anti-refugee executive order.
"The threat of repeal with no replacement has created enormous uncertainty for Americans, in the market place, and in state legislatures,” Udall said of the effort by President Trump and congressional Republicans to repeal the ACA, also known as Obamacare. The Republican-held Congress has already taken the first steps toward repeal. "My office has received hundreds of calls and emails from New Mexicans who are scared — really scared — they will lose their health care. They are frightened that needed medical care will be taken away from them, their children, their elderly parents."
"These human costs alone should convince us that ACA repeal with no replacement makes no sense. But in addition, ACA repeal would wreak havoc on our already fragile economy,” Udall continued. "The hit to our economy would be immediate, and would be sustained. Tax revenues would decrease. If the ACA is repealed and health care gets pushed back to the states – no state budget is ready to take on the extra load. Especially New Mexico’s. We will go back to the days of no care, uncompensated care, and use of taxpayer-subsidized ER services as a last resort."
Repealing the ACA would cost the state of New Mexico a whopping $93 million in federal spending starting in 2019, and $1 billion between 2019 and 2028. It would mean a loss of $2.2 billion in federal Medicaid funding in 2019, and almost $27 billion between 2019 and 2028.
“You are grappling with balancing the state’s budget,” Udall told the lawmakers. "New Mexico faces one of the highest unemployment rates in the country, coupled with one of slowest job growth rates. ACA repeal is precisely the wrong prescription for New Mexico.”
The full text of Udall’s remarks as prepared for delivery is below.
“Good morning. Thank you for that introduction, Lieutenant Governor Sanchez.
“Mr. Speaker, President Pro-tem Papen, distinguished members of the New Mexico Legislature, Tribal leaders, and honored guests: thank you for asking me to be here, to speak with you. It is always an honor to appear before you.
“I am also honored to here on this Immigrant Day of Action. We have many supporters of immigrant rights in the gallery. Thank you for your hard work on behalf of our immigrant communities, especially in these times.
“As New Mexicans, we know that immigrants contribute to our communities in all kinds of ways. They make us stronger, bringing new ideas, new energy, new enthusiasm for our country and all it stands for.
“Our president has leveled an unfair and divisive attack at immigrants. I fear his rhetoric will breed more hate and fear. We all must stand up against it.
“We need comprehensive immigration reform, not walls. We must welcome DREAMers and their families, not deport them to a country they have never known. We need real border security that will protect our communities and property – but will facilitate business and good relations. And, we should protect the rights of communities like Santa Fe and others in New Mexico to determine their own laws and protect their own citizens, not punish them for telling the federal government to do its job of enforcing immigration laws and protecting the border.
“We are a nation that welcomes newcomers. Immigrants from around the world come here because we offer hope and opportunity. Our democracy is an example for nations around the world – nations that value civil liberties, freedom, and human rights. That is why the actions by President Trump in his first two weeks are so unsettling, and so chilling.
“I strongly condemn the President’s executive order banning immigration from seven Muslim-majority countries. This ban cuts hard against America’s deepest-held values. It cuts against freedom of religion -- the very foundation of our country. It cuts against America’s long history of opening its shores to immigrants, and giving refuge to victims of raging wars and terrible natural disasters.
“The President’s ban targets refugees fleeing wars fought by armies that our government is assisting. And, it does nothing to make us safer. It puts us in greater danger. It fuels anti-American sentiment across the globe, giving terrorists the propaganda they need to claim the U.S. is not fighting for freedom, but is at war with the Muslim world.
“Silence gives license to injustice. History has taught us this lesson over and over again. Each of us should openly and forcefully denounce the President’s Muslim ban. Standing together we can defeat this injustice.
“I would like to focus the rest of my remarks today on the Affordable Care Act, and what Congressional repeal would mean for New Mexico, for the health of families, and for New Mexico’s fiscal health.
“Right out of the gate, the Republicans in Congress and the President began repeal of the Affordable Care Act. But, they didn’t put forth an alternate plan that made sure people keep the health care they have. They still haven’t.
“The threat of repeal with no replacement has created enormous uncertainty for Americans, in the market place, and in state legislatures.
“My office has received hundreds of calls and emails from New Mexicans who are scared -- really scared -- they will lose their health care. They are frightened that needed medical care will be taken away from them, their children, their elderly parents.
“Now, I’m not going to stand here and tell you the ACA is a perfect law. It’s not. But, it has helped millions of Americans, and hundreds of thousands of New Mexicans. And we should work on a bipartisan basis to improve it, not throw it in the garbage and risk millions of people’s health and hurt the economy in New Mexico and throughout the country.
“Americans don’t want to go back to the days when insurance companies could deny health insurance based on a pre-existing condition. They don’t want to go back to when insurance companies could cancel health insurance based on arbitrary lifetime benefit limits. The American people want coverage for their young adult children. And, Americans support free preventative care services. These are all signature provisions of the ACA.
“Before the ACA, New Mexico had one of the highest rates of uninsured in the country. 19.6 percent of our state did not have health insurance — almost one in five. Since the ACA, New Mexico’s uninsured rate has dropped dramatically to 8.9 percent, more than a 50 percent decrease. The ACA has made sure 300,000 New Mexicans have health care insurance — 300,000.
“Statistics in our health care discussion are important. But real people’s stories are behind the statistics. I’d like to share a few of my constituents’ stories with you.
“‘Save my daughter.’ This was the heartbreaking plea from Kevin, an Albuquerque resident. Kevin’s 33-year-old daughter, Amber, has multiple sclerosis — a tough disease, as we all know. To treat her MS, Amber must follow an exact and rigorous drug regimen, coupled with regular visits to her neurologist, and annual MRIs. The cost of her medications is $60,000 dollars per year. Amber’s doctor visits and MRIs would run into the thousands of dollars.
“Despite her MS, Amber has a job. In fact, she has a good paying job. But, her employer does not provide health insurance. Yet, Amber is able to get health insurance through the individual open market. She is able to obtain insurance because the ACA no longer allows insurance companies to deny her because she has MS.
“Amber is able to work because she gets the medical care she needs. She is able to get the medical care she needs because of the ACA. But, Kevin fears his daughter will lose the right to health insurance if the ACA is repealed. He is worried she won’t get the medical care she needs to remain healthy, to lead a normal life, to work, to contribute to society, to stay off public assistance, to survive.
“This one ACA provision — prohibiting discrimination based on a preexisting illness - protects an estimated 861,000 New Mexicans and an estimated 134 million Americans.
“It's a safe bet that all of us here know at least one person like Amber who has a serious illness that would prevent them from getting health insurance, but for the ACA. So, it’s not surprising the vast majority of Americans – close to 70 percent – want to keep this protection.
“The Kaiser Family Foundation estimates more than one-quarter of all adults under age 65 have health problems that could make them uninsurable without the ACA. If those who want to repeal the ACA get their way, all these people will be at risk.
“Kevin is also scared because the costs of treating Amber's disease are so high. Without the ACA, any insurance company could cut off her health coverage if her medical expenses exceed the company’s lifetime benefit limit. This ACA provision -- prohibiting lifetime benefit limits -- protects an estimated 555,000 New Mexicans, and an estimated 105 million Americans.
“People who need medical care the most – people with serious medical problems – have some of the highest medical costs. If those who want to repeal have their way, care for people like Amber would be wiped away. I am the father of a daughter. And I am angry that this father has to worry whether his daughter will get the medical care she needs to live a healthy and productive life.
“Mike and Pam are a husband and wife from Placitas. They own a small business. They signed up for an insurance plan under the ACA as soon as they could – because premiums before the ACA were too expensive and Pam had a pre-existing condition.
“Using their new preventive care, they found out Mike had an aggressive form of cancer. But, thankfully, doctors caught the cancer early. Mike was treated at the UNM Cancer Center, and is cured. Pam says there is ‘no question’ that the ACA saved her husband’s life.
“Because of the ACA, private health plans must cover a range of free, preventive services, everything from cancer screenings to flu shots. Over 730,000 New Mexicans now benefit. Catching disease early saves lives, and reduces health care costs. But, preventive care is expensive if you’re uninsured or poor.
“An overwhelming majority of Americans – 83 percent – support making preventive care free. But what will the President and Republicans do to make sure Pam and Mike and millions of others can keep getting cancer screenings? Nothing. They have no plan.
“Karen is the mother of two college-age children, from Albuquerque. Her son graduates in May, and turns 23. And Karen’s worried he won’t get health insurance in an entry-level job. Her concern is well founded. Young adults have the lowest rate of access to employer-based insurance. And, young adults do get sick. One in six young adults has a chronic illness – like cancer, diabetes or asthma.
“Like all moms, Karen wants her son to have medical care if he needs it. Today, the ACA allows him to stay on her insurance policy until he turns 26. This is one of the ACA's most popular provisions. The vast majority of Americans – 85 percent – want young adults to be able to get insurance.
“But those who are eager to repeal the ACA could leave an estimated 15,000 New Mexicans – like Karen's kids – and an estimated 2.3 million Americans without coverage. Because they have no plan to replace the ACA.
“We all know New Mexico is not a wealthy state. A lot of working people qualify for Medicaid. New Mexico wisely adopted the Medicaid expansion under the ACA – allowing 82,000 more people to get health care. Before the ACA, the only place many New Mexicans got health care was the emergency room. Now, those 82,000 New Mexicans have health care.
“Take Amy, her husband, and their four boys, ages 13 to 19. Amy and her husband own a family business in Santa Fe. Before the ACA, Amy and her husband went without health insurance because they couldn't afford it. They just hoped nothing catastrophic happened to them.
“As soon as she could, Amy applied for health insurance under Medicaid expansion.
Medicaid expansion covers herself, her husband, and her oldest son. Amy says she is grateful that – because of the ACA – medical bills will not ‘drain us financially.’
“There are 8.4 million people across the country just like Amy. Like Amy, they work. But they do not have high paying jobs. And they couldn’t afford health insurance before the ACA. But there is no plan for them to stay on health insurance if the ACA is repealed.
“These hard-working Americans deserve good medical care. Americans agree: 80 percent favor the Medicaid expansion for low-income, uninsured adults. We have 19 pueblos and 4 tribes in New Mexico. Native Americans make up more than a tenth of our population. I represent our Native community. And, as Vice-chair of the Senate’s Indian Affairs Committee, I represent all of Indian Country.
“Native Americans are eligible to receive care through the Indian Health Service. But IHS is severely underfunded, and long delays are common. As a result, many Tribal members rely heavily on Medicare, Medicaid, and the ACA health exchange. More than 132,000 Tribal members are enrolled in Medicaid in New Mexico alone.
“The All Pueblo Council of Governors, representing all 19 pueblos, tells me that, without the ACA, more Tribal members will go back to the days of long delays. Many will see coverage cut. IHS hospitals are heavily dependent on third party collections for clinical services. In fact, current federal funding covers less than half their operational costs.
“But, fortunately, increases in revenue – from Medicaid expansion – have offset those costs. Bottom line: without Medicaid expansion revenue, necessary services may no longer be available throughout Indian County. This is unconscionable.
“I have prepared legislation that would protect health Indian Health Services. And I will fight any cuts in federal funding if the ACA is repealed.
“So, what would ACA repeal to do New Mexico? First, the 300,000 New Mexicans who have health insurance because of the ACA will lose their health care. This includes the 82,000 New Mexicans who have health care because of Medicaid expansion.
“In New Mexico, approximately 26,000 more children are covered – just between 2013 and 2015 — largely because of the ACA and Medicaid expansion. New Mexico now insures more than 95 percent of our kids – above the national average. These children should not lose their medical care.
“If the ACA is repealed, those 861,000 New Mexicans who have a preexisting condition can be cut off from health insurance. And those 555,000 New Mexicans who have high medical costs can be cut off.
“The ACA has expanded health care in rural New Mexico, in communities that have been historically underserved, and where hospitals struggled to keep afloat and retain qualified medical professional. ACA repeal would take contract and take away care from rural New Mexico and threaten hospital closures.
“These human costs alone should convince us that ACA repeal with no replacement makes no sense. But in addition, ACA repeal would wreak havoc on our already fragile economy.
“The ACA has been an economic boon for New Mexico. Seven of the 10 fastest-growing job categories in our state are in health care. The director of BBER recently told the Senate Finance Committee that although New Mexico’s unemployment rate is second highest in the nation at 6.6 percent boosts from health care and tourism led to positive job growth for the last two months.
“If the ACA is repealed, New Mexico would lose an estimated 19,000 jobs - 19,000. That’s what NMSU economist Jim Peach said during that same Senate Finance hearing. He says ACA repeal would be ‘devastating’ for New Mexico’s economy. And the loss in spending in New Mexico would be astronomical.
“Now, I’m going to throw a lot of numbers out at you – but, this is important.
“ACA repeal would mean a loss of $93 million in federal marketplace spending in 2019 in New Mexico. And $1 billion between 2019 and 2028. It would mean a loss of $2.2 billion in federal Medicaid funding in 2019, and almost $27 billion between 2019 and 2028.
“The hit to our economy would be immediate, and would be sustained. Tax revenues would decrease. If the ACA is repealed and health care gets pushed back to the states – no state budget is ready to take on the extra load. Especially New Mexico’s. We will go back to the days of no care, uncompensated care, and use of taxpayer-subsidized ER services as a last resort.
“You are grappling with balancing the state’s budget. New Mexico faces one of the highest unemployment rates in the country, coupled with one of slowest job growth rates. ACA repeal is precisely the wrong prescription for New Mexico.
“In the end, after all the arguments about the nuances of health care policy, the statistics, the costs, we must decide whether Americans have a right to health care. For me,there is no question. Every person should be able to see a doctor when they’re sick. And that should be our nation’s guiding principle. From that principle, we can debate how to get there. And of course there will be differences, but we can work through them with civility.
“The politics of division do not work. We are witness to a more divided nation than I have seen in many decades. We must firmly and loudly reject the politics of division, and affirm the politics of working together for the common good.
“Yes, political parties will always have policy disagreements, and those disagreements will be strong. That is fine. That is democracy, where ideas compete for public approval.
“But honest disagreement over policy is very different than pitting people and communities against one another for short-term political gain. I am optimistic that all of you here will do what you can to work across the aisle and turn out a solution-oriented legislative session that will benefit New Mexico.
“Thank you again for your time. And God speed for a productive session.”