Commentary: After months of intense pressure from advocates, the UNM Hospital Board of Trustees reversed a policy, implemented in May 2017, requiring low-income, uninsured patients to pay a 50 percent down payment before surgeries. As a result of the policy, the hospital cancelled many patients’ surgeries because the patients couldn’t come up with thousands of dollars upfront to repair hernias, torn knee ligaments, broken bones, and in one case, a hysterectomy.
“We are relieved that the Hospital Board of Trustees has finally decided to treat all people with the same compassion and standard of care that insured people receive,” said Michelle Melendez, director of EleValle: South Valley Healthy Communities Collaborative. “Requiring people to pay 50 percent upfront was inhumane and not consistent with the mission of our public safety net hospital, which receives $96 million per year in property tax revenue to help cover indigent patients.”
The EleValle collaborative, which is comprised of Casa de Salud, Centro Savila, and ACCESS, teamed up with the New Mexico Center on Law and Poverty, Juntos Para la Salud, and with patient navigators from Pathways to a Healthy Bernalillo County to educate the UNM Hospital Board of Trustees about the policy’s impact on low-income, uninsured residents of Bernalillo County. The Bernalillo County Commission and the state Legislative Health and Human Services Committee weighed in on the side of advocates.
“The hospital’s policies created an insurmountable barrier for low-income patients to get surgeries, impacting their livelihoods and forcing them to suffer through worsening medical conditions,” said Sireesha Manne, healthcare attorney at the New Mexico Center on Law and Poverty. “We are grateful for the collaborative effort of community groups, patient navigators, and policymakers to hold the hospital accountable to its public mission.”
The board voted unanimously at the hospital’s board meeting on Friday to change the hospital’s Patient Payment and Financial Assistance policies. It also voted unanimously to establish a new Discount Program Policy for low-income patients living in New Mexico who meet poverty guidelines, are ineligible for Medicaid, and unable to purchase private insurance on the Health Insurance Exchange.
The new policies reinstate the hospital’s affordable down payment schedule that had been in place from 2005 until May 2017. Pathways navigators became aware of the hospital’s change in policy when clients who were seeking help with food, housing, transportation, and other basic needs disclosed that they were unable to work because of knee injuries and other debilitating medical conditions but could not afford a 50 percent down payment.
The reinstated schedule allows patients to pay $25, $75, or $300, depending on their level of poverty, upfront for surgeries that have been deemed medically necessary by their healthcare providers. The patients are then required to make monthly payments on the balance owed, which could be tens of thousands of dollars.
At the Friday meeting, Jerry McDowell, UNM Hospital board chairman, said, “There are some basic values that I think guide us: Do no harm to the patient. Consistent with our public service mission, serve all individuals with fairness, respect and dignity. Strive for best in class for quality, safety, and care. There are also legal guidelines overarching.”
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EleValle is a collaboration among South Valley organizations working together to improve the health and quality of life for residents and their families.
The New Mexico Center on Law and Poverty is dedicated to advancing economic and social justice through education, advocacy, and litigation. We work with low-income New Mexicans to improve living conditions, increase opportunities, and protect the rights of people living in poverty.