Medicaid Forward: Unlocking Affordable Health Care Coverage for All New Mexicans

By Stephen F Hightower MD FACP

“Health Care is a right, not a privilege” Edward Kennedy

fixingushealthcare.com

Friday, November 29, 2024

Dear Mr. President, Honorable Members of Congress and Distinguished Staff and Fine

Citizens,

The State of New Mexico is expanding its Medicaid program to allow all nonelderly

residents whose incomes are too high to qualify for current Medicaid, to instead purchase an

affordable plan through the program. Medicaid is currently providing high quality care to

nearly 50% of New Mexico residents. Expanding the program will make healthcare less

expensive for many people of varied backgrounds. This new program is named Medicaid

Forward.

Newly eligible individuals would pay premiums and out-of-pocket costs on a sliding

scale, with each family’s combined premiums and out-of-pocket-spending not to exceed 5% of

income. Under the proposal, Medicaid spending for most newly eligible individuals would

qualify for federal matching funds at New Mexico’s standard Federal Medical Assistance

Percentage (FMAP) of 73.26 percent. Large employers would be required to contribute to

Medicaid Forward for workers who enroll in the program. Medicaid provider reimbursements

would be raised by 17 percent for Medicaid Forward and existing Medicaid and Children’s

Health Insurance Program (CHIP) enrollees.

This innovative proposal would make most New Mexicans eligible for Medicaid coverage

at very modest costs.

If Medicaid Forward were implemented statistical analysis suggests:

• Between 407,000 and 542,000 New Mexicans would enroll in the new Medicaid

Forward option, along with some additional enrollment in traditional Medicaid and

CHIP.

• There would be between 130,000 and 142,000 fewer uninsured New Mexicans, which is

a decline from 13.1% to around 6 percent.

• Household health care spending would fall between 28.3 percent and 37.9 percent

depending on the take-up of Medicaid Forward.

• Families with incomes up to 138 percent of the federal poverty level (FPL) would see the

largest reductions in health care spending, between 39.6 percent and 49.2 percent.

• Spending would be notably lower even at incomes above 400 percent of FPL estimated

at 22.8 percent and 29.7 percent.

Assuming that Medicaid would be reimbursed at Medicaid plus 17 percent, federal

spending on health care in New Mexico would increase by between $1.8 billion and $2.4 billion.

It is also estimated that new state revenue would exceed new spending by between $3 million

and $51 million.

Medicaid typically covers pregnant women, children, poor families, and people with

disabilities. It also covers people who are elderly and need long term care, people who are in

mental health crisis, and pays for more than half the births in New Mexico. It is truly a major

necessity for many of our New Mexico citizens. Now it has an opportunity to do even more for

the Land of Enchantment.

Medicaid is paid for with federal dollars and state dollars at a ratio of approximately

70% federal and 30% state.

If the other 49 states were able to pursue a similar path and the financial challenges

could be adequately addressed, health care in the United States would certainly have a more

positive impact on our diverse, unique, and multicultural citizenry.

Respectfully submitted,

Stephen F Hightower MD FACP

fixingushealthcare.com

Copy to: We The People at fixingushealthcare.com