Summary: The Health Security Planning and Design that is underway requires a publicly accountable and transparent process for making HSA design decision and put those provisions in place so that enrollment can occur and providers can be paid. This plan and design process was funded during the 2021 Session, and additional funds are being sought this year to continue the process.
Once implemented, the statewide HSA Plan will automatically cover nearly all New Mexicans, offer a comprehensive set of healthcare services, provide freedom of choice of healthcare provider and facility (no more networks) even across state lines, and will simplify administration since it is not dependent on the costly and complicated private insurance system. The Health Security Act would enable our state to create its own comprehensive, affordable health care plan that covers almost all New Mexicans. Private insurance would play a secondary role, offering supplemental policies. The plan would exclude military members, retirees, and military families as well as federal retirees because they have their own federal insurance plan. Two groups could join voluntarily: tribes, as sovereign nations, and companies and unions that are self-insured and come under a federal law called ERISA.
Why This Legislation is Good for New Mexico:
- A 2020 study by KNG concluded that the Plan would reduce the percentage of uninsured New Mexicans to almost zero and reduce state spending by $1.6 to $2.7 billion.
- The Plan allows freedom of choice of providers without networks. Choice includes providers and health facilities across state lines.
- The Plan offers services equal to those in the state employees’ health plan, including behavioral health.
- The Plan is administered by a nongovernmental, geographically representative public commission structured much like a cooperative. No one from the insurance industry will serve on the commission. All commission meetings will be open to the public, and their account books are also public. All commissioners will receive their own coverage through the Plan.
- Premiums will be based on income, with minimums and maximums.
- Only those who are covered by the Plan are required to pay.
- The Plan preserves the existing, private healthcare delivery system.
- Employer contributions will be based on payroll and number of employees, with minimums and maximums.
- Employers and individuals who wish to purchase supplemental insurance may do so (as with traditional Medicare).
- The Plan is a New Mexico solution, with years of input from diverse New Mexicans across the state.
- Existing public dollars will be used (such as Medicaid) to help pay for the cost of the Plan.
- The plan controls costs by requiring bulk purchasing of drugs, medical equipment, and medical supplies.
- Hospitals and clinics will have guaranteed budgets and will no longer produce multi-page billing charges.
- With most New Mexicans covered by the Plan, the administrative burden on employers, providers, and health facilities will be reduced, lowering costs.
- NOTE: Medicare recipients may not be included initially because agreements will first need to be reached with the federal government to safeguard recipients’ rights.
36 cities and counties and 170 organizations across New Mexico
(See https://www.nmhealthsecurity.org for the full list.)