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Public Option, State Efforts

NM Exploring Medicaid Buy-In as a Pathway to Coverage for All

Published On July 30, 2018

Throughout the last six months, United States of Care has been listening to and learning from people across the country working to build momentum for policies that will make health care more accessible and affordable. We have been energized by the passion and commitment we’re witnessing across the country.

New Mexico is one state leading the charge to identify and advance innovative solutions. Earlier this year, a bipartisan majority of the New Mexico state legislature passed a memorial calling on the Legislative Health and Human Services Committee to study the potential for a Medicaid buy-in in the state. This week, the United States of Care team will be in Albuquerque to join New Mexico Together for Health Care, a broad coalition of families, patients, and advocates, as they meet with stakeholders to share their vision and gather input about how a buy-in plan could work best in the state.

The opportunity to purchase Medicaid coverage could be beneficial for many consumers in the state. Like families across the country, many people in New Mexico are struggling to afford high quality health insurance coverage. As many as 230,000 New Mexicans remain uninsured. Over 12,000 more are enrolled in bronze or catastrophic level coverage, which requires people to pay a significant deductible for most services, which evidence suggests oftens results in people foregoing needed care. And New Mexico has pressing health care needs, with one of the highest rates in the nation of deaths caused by drugs, alcohol, and suicide.

Medicaid is already the backbone of New Mexico’s health care system, providing comprehensive coverage to nearly one-third of the state’s residents in 2016. It’s a program that New Mexico families know well, and introducing a Medicaid option for individuals and families who struggle to afford the premiums and deductibles for their private insurance would increase competition and give consumers more choices. People in the individual insurance market can experience “churn” as their income changes and they move between Medicaid and the private insurance market. The opportunity to purchase Medicaid could help minimize the disruption that consumers currently face when their circumstances change.

We’re thrilled that New Mexico’s state legislature is undertaking a bipartisan, open and transparent process to study this issue. Health care policy is complex, and a seemingly basic change can create a ripple of unintended consequences. There are many different ways to structure a proposal to allow consumers to purchase Medicaid coverage, and it’s important to hear from stakeholders and fully understand the implications of new approaches before moving ahead.

Especially important is raising up the voices of patients and consumers who struggle to afford their insurance premiums or the co-pays and deductibles they are faced with when they need care. Our United States of Care Founder’s Council member, Lan Sena, knows all too well that having insurance doesn’t always mean being able to easily afford care. As she and members of her family have battled cancer, their worries have often been compounded by stress about the cost of accessing treatment. We believe, like Lan does, that this proposal has the potential to help her family and others in New Mexico struggling under the burden of high out-of-pocket costs.

United States of Care is focused on improving our health care system through sustainable policies so that people don’t have to worry about losing their health care based on shifting political winds. We’re excited to be assisting advocates in New Mexico with this effort, and lending expertise wherever we can be helpful – by providing research and technical support, connecting state leaders with national experts, and offering strategic outreach to stakeholders. We look forward to staying involved as this process continues and sharing what we are learning in New Mexico with other policymakers and advocates across the country, including those in the dozen other states that are currently exploring Medicaid Buy-in.