HB 376 Comments

From the Center on Law and Poverty:

 

Good day, Everyone,

Despite overwhelming support of committees of both the House and Senate and a full House vote of 60 in favor and 7 opposed our effort to secure passage of HB 376 was thwarted in the final days by Senator John Arthur Smith’s (D-Deming) policy analyst, Michael Burkhardt, who insisted that the bill be amended to require that Indian managed care enrollees be locked into membership for a year.  A compromise was sought that would have a lock-in period of three months but the proposal was rejected.  The bases of Mr. Burkhardt’s demand are not clear but it may have been tied to HSD’s repeated assertion that “the managed care program will become unsustainable when Native Americans would switch between managed care and fee for service on a monthly basis.”  The department offered no substantiation of its position.  The history of managed care enrollment by Indian people shows a consistent pattern of non-enrollment over a sixteen year period.  Only 15% of Indian Medicaid beneficiaries are enrolled in managed care out of a Medicaid population of approximately 100,000 people.  A related point of contention raised by HSD was the $108,000 state cost for technological changes which would have to be made by HSD to accommodate the purported month-by-month enrollment/disenrollment.  These issues were fully covered in the March 6 synopsis of the bill prepared by CLP attorney Quela Robinson.

 

• Under the state’s current rules, Native Americans are already afforded the option of “opting-out” of managed care during the first 90 days of any 12-month enrollment lock-in period.  Reducing the deadline to 30 days should not require a massive new influx of technology spending.
• The Affordable Care Act mandates that Native Americans are subject to a special enrollment period that permits purchasing of or changes to qualified health insurance plan through the Exchange on a monthly basis.  The ASPEN system is already required to accommodate this functionality before 2014 to permit Native Americans to transition between Exchange and Medicaid coverage accordingly.
• Lastly, any technological improvements made to a state’s Medicaid eligibility and enrollment IT systems made before December 31, 2015 are eligible for a federal match of 90/10.  That means that any changes the state makes to the ASPEN system to accommodate enrollment periods, transitions or renewals of Medicaid coverage will be re-imbursed 90 to 10.  If it is indeed true that the state will have to spend $108,000 to make this adjustment, the federal government will pay 90% of this cost.  Therefore, the actual cost to the state is $10,000.

This information highlights the arbitrariness of Mr. Burkhardt’s decision to block passage of HB 376 by preventing a hearing before the Senate Finance Committee which is chaired by Senator Smith.  The action is unacceptable. One has to ask: How is it either the purview or responsibility of a Senate policy analyst to thwart the consensus of not only the unanimously-endorsed position of tribal leadership but also of state legislative bodies that over-whelming supported the tribes’ position?  In the next several days discussions will be initiated to examine the action and a response.  It is important that the broad-based participation that was developed to work for passage of HB 376 is sustained and that we are able to gather together to construct a response that makes clear the voice of our leadership and people will not be dismissed.

 

The road to respectful co-existence has and continues to be difficult.  Jemez historian Joe S. Sando’s description of conditions leading up to the Pueblo Revolt come to mind: “Indignity was created upon indignity” and because of the indifference to the human suffering of the people, the actions of the conquerors became repugnant to the people.

Best regards, Evelyn

 

Evelyn Blanchard