News Article SF New Mexican "State still wrestling with Medicaid decision"

This article has the questions that the state has asked of CMS.
http://www.santafenewmexican.com/Local%20News/091412medicaid


State still wrestling with Medicaid decision
Kate Nash | The New Mexican
Posted: Thursday, September 13, 2012 - 9/13/12


The administration of Gov. Susana Martinez, who has yet to decide whether New Mexico will expand Medicaid coverage to more residents under the federal Affordable Care Act, is seeking answers to a list of questions before making the decision.
A letter sent by the state Human Services Department to federal health officials this week says the state has five key questions as it mulls whether to extend coverage to hundreds of thousands in the state.
“The decision on whether or not the state will expand its Medicaid program is one that is significant and that we do not take lightly,” Human Services Secretary Sidonie Squier wrote. “We must thoroughly assess the fiscal implications of Medicaid expansion, and consider them in terms of our ability to maintain current services for those New Mexicans most in need.”
For states that choose to expand Medicaid coverage to adults who live at up to 138 percent of the federal poverty level, the U.S. government would pay the entire bill, starting in 2014. By 2020, the federal share would drop down to 90 percent.
State officials estimate the number of newly eligible residents in New Mexico, where about one in five residents lacks health insurance coverage, is between 130,000 and 175,000.
As the state sorts through its options, it has these questions of U.S. Health and Human Services Secretary Kathleen Sebelius:
• Would New Mexico need to enroll everyone who is newly eligible at once, or could the state phase them in over time?
• For how long will the federal government guarantee the match it is expected to provide for states to help pay for the expansion of the program?
• If the feds provide a lower match, can states then adjust their eligibility requirements for the program?
• Could the state pay premiums for people who enroll in exchange programs instead of in the traditional Medicaid program and still receive federal matching funds? (Exchange programs are new health care plans that will be regulated by states and will be eligible for federal subsidies.)
• Could the state expand eligibility to a lesser level than 138 percent of the federal poverty level?
The department would like to hear back from federal officials in a “timely” manner, but the state hasn’t publicly set a deadline for deciding on Medicaid expansion.
Kennicott said department employees have spent countless hours on the issue. “It’s a constant topic of conversation for us,” he said. “It takes up a good deal of discussion time on any given day.”
The state for years has had among the highest rates of uninsured residents, although new census figures indicate that has eased a bit.
About 22 percent of New Mexicans were without health insurance in 2010, a figure that dropped to 19.6 percent in 2011. The uninsured rate is a problem that both Republican and Democratic officials in the past have worked to reduce.
The Martinez administration has kept its inclinations about whether to expand the program under wraps, although the first-term Republican governor has said she supports the provision that allows for children up to 26 to stay on a parent’s insurance plan and a requirement that pre-existing conditions be covered.
Without knowing more about which way Martinez is leaning, advocates of expansion are left waiting.
Veronica Garcia, executive director of New Mexico Voices for Children, in a statement this week called the expansion “an opportunity that the state simply can’t pass up in good conscience.”
So far, more than half the states have decided against expanding their Medicaid programs or are leaning against doing so, according to a report by MSNBC.com.
Contact Kate Nash at 986-3036 or knash@sfnewmexican.com. Follow her on Twitter at @katenashnm.