The Affordable Care Act (ACA) ushered in a new era of health care in America. Insurance companies can no longer deny coverage due to pre-existing conditions; lifetime and annual caps on coverage are banned; all plans must cover free preventive services; financial assistance is available low-income and middle class families; and Medicaid is expanded to people in need. New Mexico saw the largest drop in the percent of people who are uninsured, falling from 28% in 2013 to 13% in 2016. We should celebrate this incredible accomplishment and build upon our progress to ensure every person in our state and country are covered by quality health coverage.

Attacks on health care

A barrage of federal policy changes threatens to dismantle the gains we made. After several failed attempts to repeal and replace the ACA, GOP Members of Congress are now publicly discussing another attempt to dismantle the law next year. Previous versions would have capped and slashed Medicaid by over $1 trillion, dismantled the ACA’s pre-existing condition protections, raised premiums on people who need care the most, and eliminated the essential health benefits.

Congress repealed the individual responsibility provision of the ACA, which the Congressional Budget Office estimates will lead to 13 million people becoming uninsured over the next 10 years, including 90,000 New Mexicans.

The Trump administration has also taken extraordinary efforts to undo the law administratively. Over the past year and a half, the Trump administration:

1. Unilaterally ended payments that reduce out-of-pocket costs for low-and-moderate income consumers
2. Allowed states to impose burdensome requirements on Medicaid beneficiaries in order to slash enrollment
3. Expanded junk insurance that can discriminate against people with pre-existing conditions
4. Shortened the period to enroll in health coverage by half
5. Slashed critical outreach and enrollment funding

And most recently, the administration refused to defend pre-existing condition protections in court, arguing that critical protections should be struck down in case called Texas v United States. Experts say it “would have ramifications in almost every aspect of the health insurance market and the health care delivery system,” leading to widespread chaos. 27% of New Mexicans have a pre-existing condition and would be at risk of being locked out of health coverage if the court sides with the Trump administration.

States can take the lead

In the absence of leadership at the federal level, states must take action to protect the critical gains made under the ACA. This presents an opportunity to build upon what works and fix what isn’t working. Health Action NM supports a wide array of policy options that would do just that.

1. Adopt a Medicaid buy-in option to create a more affordable health care option for New Mexico
2. Build the ACA’s consumer protections into state law to protect against a negative ruling in Texas v United States
3. Creating common sense rules to ensure discriminatory substandard insurance does not flood New Mexico
4. Address the flaws of the “individual mandate” and move towards a model that actively assists people who are uninsured to sign up for $0 premium health coverage

• Maryland has proposed an innovative model that would serve NM well

What we need from national leaders

According to a 2018 survey, 92% of working-age adults think that all Americans should have the right to affordable health care. Ultimately, Americans need certainty that Congress and the federal administration will work to make the health law work and will commit to building upon the successes of the health law and identify areas of agreement. We urge leaders to come together to work for the common good and meet people’s expectation of a health system that is accessible and affordable for all people.

Voters should be informed of the positions their elected representatives hold on health care and ask people running for office about critical issues, such as:

1. Do you support the full array of the Affordable Care Act’s consumer protections, including pre-existing condition protections and essential health benefits?
2. What are your ideas for protecting and building upon the coverage gains made under the Affordable Care Act?
3. How do we get make sure every single person can get the care they need, when they need it, at a cost they can afford?

Health Action New Mexico is a 501c3 non-profit and does not endorse candidates for public office.