Governor likely bringing bad Medicaid news from D.C.
As Gov. Susana Martinez returns to New Mexico after meetings in Washington, D.C., she is probably carrying sober news back to lawmakers: Medicaid expansion is dead.
Martinez was one of the first Republican governor to embrace President Barack Obama’s initiative under the Affordable Care Act to expand the government insurance program to low-income working adults who make less than $17,000 a year or a family of four up to $33,000, and had been priced out of the private insurance market.
The reality is that New Mexico has a lot of those workers, adults who work in construction, hospitality or those who migrate between seasonal employment at jobs that don’t provide health coverage. The expansion has helped more than 220,000 residents gain health insurance, and the boost in health care hiring has likely kept the state from falling back into recession.
The program has been singled out by Republicans because it is paid for with new taxes on higher-income earners. The federal government is paying more than 90 percent of the cost for 11 million newly enrolled adults receiving Medicaid, and the Trump administration sees that as an Obama-era entitlement.
Republicans in Congress and President Donald Trump will unveil their plans this week to substantially curtail the expansion as they look to shift dollars to states that had resisted the program, many in the Republican South. They also want to see tax money used to get more people into the private insurance market.
Instead of paying for ongoing insurance coverage outright, the path forward will give states a certain amount of Medicaid money based on their population or past funding levels, according to reports. That means a cap on program growth and a cut for New Mexico and other states that have seen increasing federal dollars to support the new Medicaid patients.
Wisconsin Gov. Scott Walker is one of those governors who balked at expanding the program in his state, and a backlash against the health law is one reason Trump carried the state’s electoral votes.
Walker told The Washington Post on Friday that GOP governors “are working closely with both lawmakers and the administration to determine how to transition those living above the poverty line off the expanded Medicaid rolls.”
“Maybe I’m foolish, but I thought Medicaid is for people living in poverty,” Walker said.
For New Mexico, that likely means those adults will lose their insurance unless the state can step up and find a way to pay for it.
“Like a block grant, a per capita cap is meant to produce significant federal budgetary savings over time. That would be accomplished by setting the cap for each state significantly below what the federal government is projected to spend under current law and/or adjusting the cap by a rate well below expected cost growth,” according to a briefing paper released Friday by the Center on Budget and Policy Priorities.
“We expect House Republicans to pressure governors to accept their plans,” said Edwin Park, a health policy expert with the center during an interview with reporters. “States likely will have no choice but to drop the expansion overall.”
New Mexico would need about $330 million of its own money to maintain the current level of services for the newly enrolled Medicaid population. And that comes at a time when it is curtailing spending for public education and other services. The state already spends $913 million on Medicaid, and with federal matching money, Medicaid accounts for some $5 billion in health care services in New Mexico.
A letter was sent by many concerned organizations and individuals to Gov. Martinez over the weekend asking her to help protect Medicaid.
“We urge you to protect the health care of our people and not agree to any plan that reduces federal support for our most vulnerable people.” said the letter signed by hospital workers, AARP, the Center on Law and Poverty, as well as other organizations and health providers.
The Governor’s Office said Martinez was expected to meet with administration officials, including Health and Human Services Secretary Tom Price over the weekend, “to discuss the administration’s plans to reform healthcare and what that means for New Mexico.”
Democratic groups are quick to criticize Martinez on a variety of issues, but she has largely stood by her decision to expand Medicaid, which bucked the conservative thinking in her own party. The policy boosted New Mexico’s economy and helped to cut the rate of uninsured residents in half. More important, in a state with a high percentage of diabetes, heart disease and addiction, the expansion of the Medicaid insurance program has saved lives.
Even her proposed budget for 2018 has new money from fund transfers and premium shifts to sustain the Medicaid program without further cuts. Additionally, efforts to raise some $85 million annually by taxing hospitals and health care providers has bipartisan support among lawmakers.
Sadly, however, it is not likely to be enough. The rush to take away health care from working Americans begins this week.