While several who’ve never been capable to afford insurance are now capable to do so because of the Affordable Care Act, it is very clear to most persons that the private insurance exchanges – a huge component of ACA to solve the issue of the uninsured – is in critical trouble. A bailout by the state or federal government isn’t a reasonable option.
The great news is there is a Plan B.
Our complicated private insurance system is expensive. Contributors have to deal with various policies with several coverage, deductibles and co-pays. Dividing up the small population of state among several insurance companies leads to minor risk pools and high prices. So, it makes sense for the state to self-insure and set up our own health policy that operates just like a co-op, gives freedom of choice of contributor, involving across state-lines, and which gives a comprehensive set of services. 2 independent solutions of New Mexico researches have indicated that such a plan will mitigate rising health care prices by hundreds of millions of dollars, if not billions, within 5 years.
The Health Security Act is a viable, well-crafted, and financially sound alternative. The ACA permits for this type of alternative via its waiver for state innovation provision.
In the state of New Mexico, the insurance exchange enrollment continues to remain far below sustainable levels. Private insurers providing policies on the exchange claim they can’t make a profit without increasing premiums and other out-of-pocket prices, and, in addition, continuing to decrease the number of physicians in their networks. The low enrollment numbers, they claim, have resulted in those with larger health threats signing up under the exchange. In addition to appeals for double-digit increases in premiums, insurers are no longer providing PPO policies on the exchange, which enable even those willing to pay extra to choose out-of-network contributors.
A latest issue of the Albuquerque Journal ran a story on Presbyterian’s decision to drop out of the New Mexico health insurance exchange due to the unacceptable profit levels. Likewise, in the last year Blue Cross Blue Shield withdrew from the state exchange when regulators refused their appeal for a 52% hike. Blue Cross Blue Shield (BCBS) has since came back to the exchange, but is now claiming a 93% premium increase.
Medicaid now covers 40% of New Mexico residents, with added prices to the state, resulting in cuts in amounts to physicians and hospitals. The affect of this recent Department of Human Services decision will be to decrease the number of contributors willing to accept Medicaid. It might also result in cost shifting – raising the cost of care for those patients not on Medicaid to compensate for the lower amounts.
And, of course, pharmaceutical costs continue to increase in double-digit percentages.
Gas and oil revenue has been meager and tax cuts approved in last legislative session have negatively impacted state revenues. The strapped budget of state has resulted in the series of declared austerity measures at the institutions of larger learning and public school districts.
Rising health care prices will sustain to compete with other significant state requirements. Something requires to be done to deal this situation. The Legislature convenes on the day of Jan. 17, and the Health Security Act, which will be launched at that time, gives a well-thought-out alternative to the ongoing issues of health expenditures and access.
The support for the Health Security Act is there. 34 counties and municipalities from Santa Fe to Roswell have endorsed it. Over 145 diverse New Mexico agencies need to see it approved. A solutions of New Mexico in support of the plan was approved at the state League of United Latin American Citizens convention previous month.
Now it is time for the legislators to get completely on board to make this solutions of New Mexico happen. Now is the period to make the voices heard on this problem.