When the recent Supreme Court ruling upheld the constitutionality of the health care reform law, it also opened up new questions about Medicaid that were explored at length by Winthrop Quigleys UpFront piece Medicaid Expansion the Next N.M. Debate.
Although Gov. Susana Martinez has publicly questioned whether its in New Mexicos best interest to comply with expanding Medicaid starting in 2014 as part of the Affordable Care Act, opting out wouldnt just be a burden to my hospital and the patients I treat it would be turning down the deal of the decade.
The law expands health care coverage in two ways.
The first is by creating health insurance exchanges for individuals and small businesses to shop for comprehensive insurance plans at a subsidized rate. To her credit, the governor has moved New Mexico forward, and our state exchange is finally in the works.
The second is by extending eligibility for Medicaid. Medicaid, which currently only covers low-income citizens who meet certain conditions, will be expanded to cover all single adults making a little less than $15,000 per year and a family of four making about $30,000 a year. Expanding Medicaid alone would give coverage to an additional 170,000 New Mexico children and adults. But the Supreme Courts ruling gives states the option of rejecting this expansion and the federal dollars that come with it, as Quigley pointed out.
Rejecting this funding would be a disaster for New Mexico.
I saw the patients who would benefit from this expansion while I was training as a resident physician at University of New Mexico Health Sciences Center in Albuquerque. Most of them come from hardworking families. They play by the rules, pay their taxes and want whats best for their children.
But the astronomical cost of health insurance places it out of reach for their family budgets. As a result, too many of them cut back on the care I prescribe for their conditions and far too many of them skimp on preventative care that keeps them healthy in the first place all because they cant afford it. But even if I were unmoved by the precariousness of my patients financial stability, I would find the effect of the Medicaid expansion on my state and my countys fiscal well-being to be equally compelling.
Right now, hospitals and providers are treating the 24.7 percent of New Mexicans who are uninsured, and too often that treatment remains uncompensated care because the patient is simply unable to pay. In fiscal 2011, UNM alone reported providing $198 million in charity care and care for the uninsured.
Who pays for this uncompensated care? We all do.
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Telemedicine services for veterans get a shot in the arm in a new bipartisan supported bill introduced in the House last week.
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