2021 JANUARY 23 ISSUE: LOBBYING EFFORT FOR N.M. HEALTH CARE SOLUTION

The Corrales-based campaign to establish near-universal, affordable health care for New Mexicans is gearing up for a final push in Santa Fe later this month. The 2021 session of the N.M. Legislature begins January 19. “Now the time has come to roll up our sleeves and create the critical design elements that must be in place prior to the start-up of the plan,” Mary Feldblum urged. “The legislation that is being introduced in 2021 specifies how this will be accomplished.”

For decades, Feldblum has directed the Health Security for New Mexicans Campaign based here which has garnered statewide support from doctors, hospitals and more than 170 local governments and organizations. “Everything we have worked for all these years, to give all New Mexicans the best possible secure health care coverage, is now within reach.”

The 2021 legislation would establish advisory committees and enlist public input for a Health Security Planning and Design Board “whose members will have various areas of expertise (health policy, management, finance, systems design, etc.),” Feldblum explained.

A second step to be launched by the 2021 legislation would be “creation of a geographically and demographically representative Health Security Plan Commission, consisting of consumers, business owners, health care providers and health facility representatives,” she added. “This commission, which will be responsible for administering the plan, will complete the final design elements, conduct a cost analysis of the plan as designed, develop a funding system based on real numbers and, finally, seek legislative and executive approval so plan enrollment can begin.”

Even if the next session of the legislature approves the next steps, as expected, it will still take several years before it can go into effect. “It will take an estimated three years to work out all the details to make certain that the Health Security Plan will perform according to expectations,” she said. “We know that is a long time, but a lot of careful planning and decisions need to be made to ensure that this innovative solution performs smoothly from the start.”

The elections last month improved prospects that the plan can be implemented. “It has brought some very positive developments for Health Security. The N.M. Senate, long a roadblock for Health Security, has moved in a much more favorable direction.  We will have different senate leadership in 2021, and there are several new senators who support the Health Security Plan. The path for moving forward is now open.

“In addition, a Biden victory means that it will be much easier for our state to receive the federal waivers needed for the Health Security Plan. So now is the time for the big push.” County governments that have called for passage of the Health Security Act include Bernalillo, Sandoval, Cibola, Valencia, Doña Ana, Grant, Guadalupe, Hidalgo, Los Alamos, Luna, Mora, Otero, Rio Arriba and Taos, among others.
Municipal governments endorsing the plan include: Corrales, Albuquerque, Rio Rancho, Santa Fe, Las Cruces, Bayard, Belen, Carlsbad, Deming, Ft. Sumner, Grants, Hatch, Las Vegas, Los Alamos, Los Lunas, Mesilla, Roswell, Taos and Silver City, among others.

As expected, legislators have been cautious about setting up a state-run near-universal health care system without knowing the costs. So in the 2019 session, they appropriated nearly $400,000 for a comprehensive analysis of the plan’s economic feasibility. The results basically confirmed two earlier studies. (See Corrales Comment Vol. XXXVII No.20 January 5, 2019 ‘Health Security Act’ Could Pass N.M. Legislature.”)

The most recent and thorough analysis by KNG Health Consulting of Rockville, Maryland and Reynis Analytics in Albuquerque “confirms what two previous studies determined: the Health Security approach guarantees universal health care coverage and control rising health care costs,” Feldblum said “These conclusions show why we need to proceed now with the next phase, setting up the Health Security Plan.”

She cited the KNG report on page 48 as “Over our five-year projection window, the Health Security Plan is projected to reduce health care spending in the state” with savings over the five-year period estimated at $1.6 billion to $2.7 billion depending on the scenario analyzed.

That’s even with what KNG refers to as “near-universal coverage” that would reduce the percentage of uninsured New Mexicans to almost zero.
Feldblum had been critical of KNG’s draft report, but was relatively pleased with revisions made for the final report. “We were pleased to see adjustments and clarifications in response to our feedback,” she said.

She noted that in the report’s introduction the analysts wrote “In some scenarios, the Health Security Plan may be funded through existing revenue, while in other cases there may be a funding shortfall.”

She added, “In fact, the fourth scenario produces a funding surplus. It provides a clear pathway to a viable funding approach. In the other three scenarios, the shortfalls decrease with year. New programs generally cost more at the beginning, so this is not surprising. The key finding is that it is possible to fund the plan in a way that results in a surplus, not a shortfall.”

Factors in the report yielding that result include:
• reduced administrative costs after merging Medicaid, state employees and the State’s existing health insurance exchange programs;
• lower drug costs through bulk purchasing;
• reduced billing and insurance costs for hospitals and health care providers;
• stabilized hospital revenues through global budgets for a guaranteed funding stream that allows hospitals to invest in better systems of care; and
• lower worker compensation and automobile insurance premiums.
“While the 2019 Health Security Act described guidelines to be followed when developing the Health Security Plan, there are many specific decisions that need to be made,” Feldblum explained in a December 4 newsletter. “For example, how providers and health facilities will be paid, how the bulk purchasing of drugs program will function, how the appeals system will work for consumers, providers and health facilities, and many, many more.”

She urged citizens to press their legislators to adopt the Health Security Plan bill during the upcoming session of the legislature. “New Mexicans cannot afford, quite literally, to wait any longer to set up our own Health Security Plan. We must make sure that legislation is passed now, in 2021, so that the detailed set-up decisions, which will take time and include lots of public input, can finally be worked out,” she added.