The behavioral health shakeup continues to cripple the state’s fragile behavioral health system.  In 2013, the Martinez Administration shut down the offices of dozens of mental health providers, claiming that they fraudulently overcharged Medicaid for services.  Two years later, the administration has yet to provide evidence that the charges were fraudulent and the system remains in disarray.  The human cry now is for a roadmap forward.  Systemic reform has been attempted before several times in New Mexico.  And still, too many people, including thousands of children, are not getting the critical services they need, and they pay with the quality of their lives.  And ultimately everyone pays - not to mention the basic right to health care. Isn't it time for a well-thought-out reorganization of a system that builds on what can work?  

-       Barbara Webber, Executive Director

New York to offer more affordable coverage options to low/moderate income residents.   New York is moving forward with its Basic Health Plan, a health coverage option available to those making between 133% and 200% of the Federal  Poverty Level (FPL).  Many consumers still struggle to pay the monthly premiums offered on the private marketplace.  This new program will reduce barriers to care and reduce the “churn” between Medicaid and the exchange for people whose incomes fluctuate month-to-month.  According to the Times Union, “consumers with income at or below 150% FPL ($17,655 for a household of one, or $36,375 for a household of four) will pay no monthly premium. Those with slightly higher incomes at 200% FPL ($23,540 for a household of one, or $48,500 for a household of four) will pay $20 a month.”   

Given the state of New Mexico’s economy, it would make sense to consider this option.  State Senator Gerald Ortiz y Pino introduced a memorial to have legislative staff study the idea, but it didn’t come to a vote in the House.  Affordability remains the key barrier to accessing health coverage and care.  It’s time for New Mexico to start taking this idea seriously.

-       Colin Baillio, Communications and Outreach

New Mexico keeps its exchange but will continue to use the federal website.  Several weeks ago, the board of the New Mexico Health Insurance Exchange (NMHIX) voted to scale back funding for their IT system in order to prioritize other goals, such as providing outreach and enrollment services, marketing, and continuing the current level of staffing.  This decision was made after the federal government rejected a $90 million grant proposal drafted by NMHIX.   Without that funding, the board had to decide how to best use current funds.  Our view is that this was the best choice, given that the federal website is functional while many state websites continue to struggle.  Plus, the benefits of coordinated outreach and enrollment efforts are more important than having our own website.  After the first two years of sign-ups, we know that these services are the most effective way to inform consumers about new coverage options and help decide what kind of coverage they want.  Moving forward, outreach and enrollment assistance should be the exchange's primary tools for increasing understanding about new coverage options and enrollment numbers.

-       Joe Martinez, Consumer Outreach Coordinator

The tax season health coverage enrollment period is almost over!  Consumers who found that they owed a penalty for lacking insurance in 2014 can get covered and avoid next year’s heightened penalties.  So far, 68,000 people have taken advantage of this opportunity, which ends on April 30, 2015. Health Action New Mexico has created a bilingual consumer resource for those who want enrollment assistance during the tax enrollment period.  We hope a similar opportunity will be in place for consumers next year when the penalty increases to the greater of $625 per person or 2.5% of income.  However, more coordination needs to take place between NMHIX and tax preparers so that consumers can take advantage of the opportunity when they file taxes.  Don’t miss out on this opportunity to get covered if you are uninsured!

-       DeAnza V. Sapien, MS JD, Administration and Grant Development