Experts: Repeal plan would hit state hard

GOP proposal would end expanded Medicaid, nix billions in federal funds

New Mexico’s expanded Medicaid program, which covers about 250,000 people, would come to an end under the latest proposal before the U.S. Senate to repeal the Affordable Care Act.

Along with 30 other states and the District of Columbia, New Mexico expanded access to Medicaid to low-income adults under the Affordable Care Act. The latest legislation aimed at repealing the 2010 law would end expanded access to Medicaid and the federal funding that goes along with it.

Critics say the plan would scrap health insurance for New Mexicans newly eligible for Medicaid, leaving them with lower-quality coverage. It also would cut billions of dollars in federal funding for the state and a segment of the economy that has proven a bright spot while New Mexico’s unemployment rate has ranked among the country’s highest.

And a spokesman for Republican Gov. Susana Martinez raised concerns Wednesday that the push would ultimately hurt New Mexico.

But the legislation’s authors, Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, have touted the measure as divvying up money for health care based on state populaNew

tions. They say their measure would create a fairer system of funding health care while giving states more flexibility.

Still, analysts say states such as New Mexico would feel a pinch.

“It would end the expansion altogether,” said Robin Rudowitz, associate director at the Kaiser Family Foundation Program for Medicaid and the Uninsured.

Data released last week by the U.S. Census Bureau showed that the share of New Mexicans without health insurance was cut in half between 2013 and 2016, from 18.6 percent to 9.2 percent.

Under the bill by Graham and Cassidy, the federal government would give states money to cover the costs of insurance for low-income adults. But, Rudowitz said, such insurance would not have to meet the same standards as required under the Affordable Care Act, raising concerns about the care of those with pre-existing conditions.

And New Mexico would end up with less funding per resident to subsidize care for low- and middle-income people, according to analysis by the consulting firm Avalere.

The firm estimated Wednesday that New Mexico would lose about $5 billion in federal funding between 2020 and 2026. It would lose even more money after that if Congress did not find a fix.

“The Graham-Cassidy bill would significantly reduce funding to states over the long term, particularly for states that have already expanded Medicaid,” Caroline Pearson, senior vice president at Avalere, said in a report issued Wednesday morning.

Some of the potential impact is still unclear.

The left-leaning Center for American Progress estimated Wednesday that 230,000 fewer New Mexicans would have health insurance in a decade if the bill became law. The Congressional Budget Office, meanwhile, told lawmakers it would have a preliminary assessment of the law by early next year, but an in-depth analysis would take longer.

Still, Republicans are pressing ahead with the bill. Special parliamentary rules for approving such legislation with a simple majority of senators rather than a three-fifths majority are about to expire.

The last-minute push to fulfill what amounted to a campaign pledge for President Donald Trump has generated opposition, even from some Republican governors whose states stand to lose funding and insurance coverage if the Graham-Cassidy bill passes.

A bipartisan group of 10 governors, including several from Western states, sent a letter to Senate leaders Tuesday asking them to stop the Republican health care bill.

New Mexico’s Republican governor, Susana Martinez, who chose to expand access to Medicaid, responded through an aide Wednesday to questions about the Graham-Cassidy proposal but did not say whether she would back it.

“What’s perfectly clear is that Obamacare is a complete disaster,” said Martinez’s press secretary, Joseph Cueto. “While it’s encouraging that Congress is working on a health care solution, the governor is concerned this bill could hurt New Mexico and still needs some work. She believes we need a bipartisan approach that focuses on the insurance market to make health care affordable.”

Brent Earnest, secretary of the New Mexico Human Services Department, told a state legislative committee Wednesday in Albuquerque that reviews of the bill don’t bode well.

“In most of these proposals, New Mexico loses,” Earnest said.

And Democrats representing New Mexico in Congress have said the proposal would leave the state on the wrong end of health care reform.

“These cuts would almost certainly force hospitals and clinics to close and leave families across our state with few options for care when they face an illness or need to see a doctor,” U.S. Sen. Tom Udall of New Mexico said on Wednesday. “The Graham-Cassidy TrumpCare bill brings us back to a time when the big insurance companies were allowed to charge New Mexicans more for being sick.”

Contact Andrew Oxford at 505-986-3093 or aoxford@sfnewmexican.com. Follow him on Twitter @andrewboxford.