BernCo looks at Medicaid buy-in option

Commissioners to consider resolution of support tonight

Bernalillo County commissioners are expected to consider a resolution this evening asking state officials to develop a Medicaid buy-in plan, which is gaining attention nationwide.

If approved, the resolution would be sent to the New Mexico Legislature and governor in support of a public option buy-in for health care coverage, even for those not currently eligible for Medicaid.

Reyna Tovar, a Partnership for Community Action health care advocate and Bernalillo County resident, said in an email that the Medicaid buy-in concept is important because all New Mexicans are in need of health care coverage.

The resolution commissioners will consider states that “the plan is an innovative way to reduce healthcare costs and

respond to federal actions that are driving up costs, causing people to lose coverage and creating uncertainty in insurance markets.”

But critics question the expense of such a system, the expansion of government involvement in health care and how it would be funded.

The resolution is sponsored by Commissioner Steven Michael Quezada. According to the resolution, more than 180,000 New Mexicans do not have health insurance, including more than 54,000 Bernalillo County residents. And low-income patients who do buy plans on the health insurance exchange can expect to spend 8 to 30 percent of their income or more on total out of pocket health care costs, according to a cost estimator from New Mexico’s Superintendent of Insurance.

The buy-in concept is gaining attention across New Mexico and the country.

During the 2018 New Mexico Legislative session, both the House and the Senate passed memorials to commission a year-long study of possibilities for expanding health care coverage by allowing more people to buy into Medicaid.

But Sen. William Sharer, R-Farmington, described the Medicaid buy-in idea to the Associated Press during the session as a step toward more burdensome regulation and government mandates.

“I think if we’re going to do this study we also ought to study how to get back out of this rush to make health care a right,” he said.

According to the National Academy for State Health Policy, possible disadvantages include the fact that Medicaid’s lower provider reimbursement rates could diminish provider participation and in some states it may not be politically feasible to broaden the scope of Medicaid, even if individuals are required to pay premiums for coverage.

Several states including Colorado, Maryland, Massachusetts and Nevada have introduced legislation or initiated studies to explore the option of offering a Medicaid plan for consumers.

Two bills were introduced in Congress in October 2017, including the State Public Option Act, cosponsored by Sen. Brian Schatz, D-Hawaii, and Rep. Ben Ray Luján, D-N.M., and the Health Care Affordability and Choice Act, sponsored by Rep. Michelle Lujan Grisham, D-N.M., that would permit all states to provide Medicaid as a buy-in coverage option for their residents to purchase without the need to apply for a federal waiver.

“Our goal with this bill is simple — to expand the availability of low-cost, high-quality health plans to all Americans by establishing a state public option through Medicaid,” Luján said in a statement. “Our bill builds on a system that already works — a system that is already in place in every county in every state in the country; and a system that has built-in efficiencies.”

Sunland Park’s City Council passed a resolution supporting the state’s effort last month. The McKinley County Commission did the same in June.

NM Together for Healthcare is a coalition of public health groups — which include Strong Families New Mexico, Partnership for Community Action, New Mexico Center on Law and Poverty and Health Action New Mexico — advocating for the concept.