Register Now
Why register?
Login
 The leading web portal for pharmacy resources, news, education and careers November 21, 2017
Pharmacy Choice - Pharmaceutical News - New Mexico hospitals, clinics cite concerns over health care reform [Las Cruces Sun-News, N.M.] - November 21, 2017

Pharmacy News Article

 7/17/17 - New Mexico hospitals, clinics cite concerns over health care reform [Las Cruces Sun-News, N.M.]

July 17LAS CRUCES Efforts in Congress to repeal and replace the Affordable Care Act, also called Obamacare, have sparked concerns among hospitals and clinics across New Mexico, including in Las Cruces.

The most recent version of the legislation, the revised Better Care Reconciliation Act, was released Thursday by Senate leaders, but health care providers said it doesn't alleviate their worries.

At issue are provisions that likely would reduce spending for or trigger an elimination of a much-discussed Medicaid expansion that New Mexico OK'd in 2013. In addition, proposed changes to the traditional Medicaid program, which covers the poorest population, are expected to result in less federal funding for the state, if the bill passes.

'Devastating to rural health care'

John Harris, CEO of Memorial Medical Center in Las Cruces, said Friday that the bill's current version would be "devastating to rural health care in the state of New Mexico." Harris said the whole state, Las Cruces included, qualifies as rural, with much of the population relying on Medicaid or Medicare for its health coverage.

"As proposed, we really think the funding reduction for Medicaid that's incorporated into BCRA will leave millions of Americans without coverage," he told the Sun-News.

"It is a concern to us, and it is a concern, frankly, to every hospital in the state of New Mexico," Harris said. "Because the Senate bill as proposed is not significantly different than the plan that passed the House earlier in the year in terms of its impact on rural health care and its impact on our community members."

The Medicaid expansion, as well as heightened public awareness about Medicaid, resulted in nearly 267,000 adult New Mexicans enrolled, according to a report by the Burrell College of Osteopathic Medicine. The expansion covers a group, sometimes referred to as the working poor, who earn between 100 and 138 percent of the federal poverty level.

At Memorial Medical Center, Harris said, 49 percent of clients have Medicaid.

"That's half the patients that come to Memorial, and I would submit that it's a major portion of who goes to MountainView (Regional Medical Center)," he said. "But you get into some of the rural communities, like Deming, Silver City, Truth or Consequences and frankly almost any community in New Mexico, they're going to be impacted in some cases even more because they have a higher Medicaid population. If reimbursement for Medicaid is not adequate, it could cause the closure of some hospitals."

Hospitals, via their emergency rooms, are obligated to treat all people who show up at their doors, regardless of a person's insurance coverage level or ability to pay.

Hospitals have more recently been getting paid for patients that historically they've treated without reimbursement, Harris said.

Governor responds

The bill's likely effects are a reduction in the number of patients with expanded Medicaid and an increase in the number of uninsured patients something hospitals struggled with before the Affordable Care Act, Harris said. And reimbursement rates for remaining Medicaid enrollees could decline.

Gov. Susana Martinez OK'd the Medicaid expansion in New Mexico in 2013, despite expressing opposition to Obamacare. Asked about her stance on the Senate's recent health care reform bill, she replied in a prepared statement:

"The fact is, Obamacare has been a complete disaster, I want to see a plan that protects those most vulnerable New Mexicans while cutting healthcare costs which skyrocketed under Obamacare putting hardworking families in jeopardy. While I'm still thoroughly reviewing the new bill with additional amendments, there are parts of it which I find encouraging. For instance: The bill calls for at least $45 billion to be set aside to combat opioid abuse; abolishing many of the damaging fees imposed on working families and businesses by Obamacare; and removing several taxes which have hurt New Mexicans like taxes on medicine and medical devices.

Continued Martinez: "More work needs to be done, but it's encouraging that while Congress works through healthcare reform, the administration has given states a voice and a seat at the table. New Mexicans deserve a healthcare solution that puts our families ahead of politics."

Congressional delegation

U.S. Sen. Martin Heinrich, D-N.M., criticized the Republicans' proposal in a recent news conference, saying the changes to Medicaid would hurt rural hospitals.

"Rural hospitals really stepped up when we passed the ACA," he said. "They came to the table, and they accepted lower payment rates in exchange for covering people who were not covered people who they were giving health care to who were not able to pay for it, the uninsured who were showing up in their emergency rooms. This bill rolls that coverage back, but it doesn't give them the higher payment rates they were receiving before."

U.S. Rep. Steve Pearce, R-N.M., said in a statement: "Obamacare is in full collapse, and without a solution, New Mexicans will continue paying increasing premiums and deductibles. The House-passed bill, while not perfect, begins to address the failures within Obamacare."

"This bill will continue to evolve as it moves through the legislative process," Pearce said. "I look forward to reviewing that final product and how it will assist New Mexicans. It is my hope that Congress can make productive changes that take the financial burden off the backs of middle-class and working families, while protecting New Mexico's most vulnerable."

U.S. Sen. Tom Udall, D-N.M., said the most-recent Senate revision of the health care reform is "still a terrible deal for regular New Mexicans."

"It still guts spending for Medicaid and would force almost 300,000 New Mexicans to lose their health care," he said in a statement. "It still would devastate New Mexico's economy, killing almost 50,000 jobs. It still would slash funding that rural hospitals and clinics rely on, forcing some to close including one I visited last week in Fort Sumner."

Cuts in federal funds proposed

Jeff Dye, CEO of the New Mexico Hospital Association, said the proposed federal legislation would reduce health coverage for people, and hospitals would incur more uncompensated care.

"New Mexico is an expansion state," he said. "We gained a lot through Medicaid expansion, but we now stand to lose a lot as a state."

The Medicaid expansion initially launched in New Mexico with the federal government reimbursing 100 percent of the cost, with a phased reduction expected to reach 90 percent and the state picking up the rest of the tab, state officials said. That's in comparison to traditional Medicaid, for the lowest-income population, in which the federal government reimburses a lower percentage of care.

David Roddy is health policy director for the New Mexico Primary Care Association, which represents about 20 members, including La Clinica de Familia in Las Cruces, and operates 160 primary-care, behavioral health, dental, and school clinics across the state. Since the ACA took effect in 2013, the clinics have increased their client load from 290,000 to 325,000, thanks to more coverage by Medicaid and marketplace insurance.

"The impact of the ACA is that we're now serving about 35,000 less uninsured, and we've been able to expand capacity by 10 to 12 percent," he said.

"Were Medicaid expansion to be rolled back and the predictions nationally are that we would go back to the same level of uninsured we saw back in 2013 we could lose 200 clinicians. And basically, for one-third to one-quarter of our patients, we would not be able to serve them."

Patients wouldn't be turned away, Roddy said, but they might have to wait months to see a doctor.

Under the Senate reform bill, the reduction in the percentage of care paid for by the federal government for new enrollees in the Medicaid expansion wouldn't stop at 90 percent, according to the Center on Budget and Policy Priorities. It would drop to 75 percent by 2023 and then down to the traditional reimbursement rates for each state.

Under the proposed reform, care for current New Mexico enrollees in the Medicaid expansion would continue to be reimbursed by the federal government at existing, higher rates, state officials said. But residents who fell out of enrollment or failed to meet stricter paperwork standards for maintaining enrollment, would no longer be reimbursed by the federal government at that high rate.

In some states, including New Mexico, the proposed reduction to the federal matching dollars would trigger an automatic or nearly automatic end to the Medicaid expansion in future years because of state-imposed conditions, according to the CBPP. In addition, a per-capita Medicaid cap is proposed, rather than the need-based current system, which is constrained mainly by the state's ability to match federal funds.

States could opt to begin paying more into their Medicaid programs to minimize the effects of reduced federal payments to states.

But Sen. John Arthur Smith, D-Deming, said New Mexico's budget is already strained. Now, about $1 billion in state funds is matched by $5 billion in federal funds to pay for Medicaid.

"If we only drew down $4 billion, and the state had to come up with another $1 billion (to maintain the existing funding level), those are huge, huge numbers," he said.

Asked what he believes Congress should do, Smith replied: "Off the top of my head, they're going to have to be responsible, and entitlements are going to have to be included in a reduction if you're ever going to balance the budget. But you're going to have to do it in a phased-in approach."

Smith said any federal reductions should be made over a decade, with states being told exactly how much spending will be cut. That gives more time to plan.

Harris, CEO of MMC, said he believes the debate boils down to "is health care a right or is it a privilege?" The current bill creates a lot of uncertainty for low-income residents.

"If we continue with things like BCRA, these citizens won't be able to receive the care they need, where they need it and when they need it," he said. "We've got to fight to protect the current Medicaid level we have in New Mexico and the current Medicaid budget. Because it is such a huge amount of the health care that is provided in the state of New Mexico. It really is incumbent upon us to pay very close attention to what is going on in Washington, D.C."

Diana Alba Soular may be reached at 575-541-5443, dalba@lcsun-news.com or @AlbaSoular on Twitter.

-

(c)2017 the Las Cruces Sun-News (Las Cruces, N.M.)

Visit the Las Cruces Sun-News (Las Cruces, N.M.) at www.lcsun-news.com

Distributed by Tribune Content Agency, LLC.




Pharmacy News Index
  Drug Delivery Systems
  Drugstores
  FDA Final Approvals
  Front Page Healthcare News
  Generic Drugs
  Hospital Industry
  Internet Pharmacy
  IT in Healthcare
  Medicare & Medicaid
  Over-the-Counter Drugs
  Pharm Industry Trends and Policy
  Pharmaceutical Development
  Pharmaceutical Industry

LIVE ONLINE CE

Last Chance
Nov 22: Medical Marijuana: Examining the Science, Not the Politics
Nov 27: Drug Diversion and the Law: Updates and Considerations
Nov 28: An Integrative Approach to Managing Arthritis
Nov 29: Influenza 2017-2018: An Update on Prevention and Treatment
Nov 30: School is Out! Life is in Session: The Importance of Professional Development in Pharmacy
Click for entire Webinar Calendar

Special Announcement

Free Membership
Enjoy Drug Search, industry newsletters and more...

Nursing Jobs
Are you a nurse looking for a job?

Check out the Nursing Job Source.

Your number one choice for nursing jobs.



Websites » RxCareerCenter.comRxSchool.comClubStaffing.comNursingJobSource.comRN.com
Copyright © 2017 Pharmacy Choice - All rights reserved.
Terms and Conditions | Privacy Statement
888-682-4415