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					Briefing on
Insure New
  Mexico!
Council for
 Medicaid
 Advisory
Committee
August 15,
  2005

              0
                                                  Reminder . . .
   2003 – Health Care Coverage and Access Task Force

   2004 – Insure New Mexico! Council
       Charges:
         – reduce number of uninsured
         – increase number of employers offering insurance
       34 Recommendations, 6 passed legislature

   2005 – Working on Remaining Recommendations and
    Limited New Ones
       Report due to Governor in December 2005
       Minutes on www.insurenewmexico.state.nm.us.



                                                                   1
                                   Insure New Mexico!
                       Legislation Signed by Governor
                       2005 Legislation
   Expand the Functions and Reduce Rates of the Health Insurance
    Alliance - < 10,000 lives
   Allowing Individual Health Care Coverage of Unmarried
    Dependents until their Twenty-Fifth Birthday - < 4,000 lives
   Require Insurers to Offer Insurance Coverage for Certain Part-
    Time Employees - < 4,000 lives
   Small Employer Insurance Program (GSD) - < 3,000 lives

                         FY06 Budget
   Implement the State Coverage Insurance (SCI) Program ($4
    million general fund) - < 10,000 lives
   Medicaid Outreach to Enroll Native American and Hispanic
    Children ($1 million general fund) – < 5,000 lives



                                                                     2
                  Insure New Mexico! Council – Remaining Initiatives

A. Increase Insurance Options
1.  Require insurers to offer domestic partner health insurance benefits to
    employers of any size who want to provide this coverage. [L 2006
    – Mimi Stewart wants to carry]

2.   State-subsidized reinsurance plan similar to HealthyNY model. [L &
     B]

3.   Essential benefits with less mandated benefits and annual or
     lifetime caps. (Maes and Beffort bills) [L 2007 – Beffort wants to
     carry] Subcommittee looking at Minimum Healthcare Protection
     Act, HMO Act & creation of standard benefit package (ala TX)
     with and without mandates

     NOTE: HSAs considered and not considered important to charge
     of increasing the number of uninsured, and no legislation needed
     for market to do them within current law.
                                                                              3
                   Insure New Mexico! Council – Remaining Initiatives

B. Tax Incentives for Small Employers [2006]
1. Tax credit for businesses that provide health insurance for part-time
   employees working at least 20 hours a week. This credit is
   estimated to benefit 7,000 part-time employees (a total of 10,000
   individuals, with families). [L & B ~$15 million]
2. Graduated tax credit for small businesses (25 employees or less OR
   less than 10 employees) that offer health insurance for their
   employees. Small businesses currently offering health insurance
   would receive a five percent tax credit, while small businesses not
   currently offering health insurance would receive a 10 percent tax
   credit declining to five percent in the second year. This tax credit
   is designed to entice small businesses to begin and continue to
   offer health insurance for employees. This tax credit is estimated
   to benefit 5,000 employees (a total of 7,500 individuals, with
   families). [L & B ~$9-18 million; Varela and Grubesic carried]
3. Tax Credit for small businesses offering insurance for families with small
   children. [L & B] or for low-income employees.
                                                                                4
                 Insure New Mexico! Council – Remaining Initiatives

C. Medicaid [2006]
1. Increase Medicaid coverage adults up to 100 percent of the federal
   poverty level (FPL) by developing a limited benefit plan for such
   adults with appropriate cost-sharing, beginning with adults w/
   children up to 50% FPL (currently ~ 33% FPL). (< 11,000 lives @
   ~$22 million GF) [B & R]
2. Increase coverage for:
      Prenatal care up to 235% FPL (now 185%) [B & R; K Martinez] (< 1,200
       women ~$3.9 million GF).
      Infants and toddlers up to 300% FPL (now 235%) [B & R; K Martinez]
       (< 7,800 children to age 19 @ ~$3.8 million GF).
3.   Increase aggressive outreach to families with children (bring
     enrollment from 411,000 projected at end of FY 2006 up to 430,000
     by end of FY 2007 @ ~ $14.6 million GF annualized). [B]
4.   Expand SCI ($4 million GF for ~ 7,000 lives). [B]


                                                                              5
                       Insure New Mexico! Council – Remaining Initiatives

D. Use New Mexico Clout [2006]

1.   Expand the use of federally-qualified health centers (FQHCs) and primary care clinics.
     [B ~ $2 million]

2.   Increase use of telehealth and electronic billing. [L? & B]

3.   Develop in-state healthcare capacity in New Mexico so fewer dollars are spent out-
     of-state and are instead redirected towards in-state providers. [R]

4.   Give preference in doing business with the state or getting access to industrial
     revenue bonds to companies who offer health insurance for their employees.
     The Governor should call on New Mexico businesses to give preference to
     vendors, contractors and suppliers that offer health insurance for their
     employees. [EO or L & R – GSD, Economic Development and/or All State
     Agencies]




                                                                                        6
              Insure New Mexico! Council – Remaining Initiatives

E. Increase Knowledge of Health Insurance Options [2006]

1.   Educate the public regarding prevention and wellness
     and the link to reducing the cost of health insurance
     premiums. [B]

1.   Train brokers and increase HIA’s outreach capacity to
     small businesses. [B]




                                                                   7
                     Insure New Mexico! Council – Remaining Initiatives

Revenue to Pay for Recommendations

1.   Close the tax loophole for smokeless tobacco products and target to
     uninsured. From 25 percent to 40 percent = ~ $2.3 million. [L – Gail
     Beam was interested.]
2.   Increase liquor excise tax and target to uninsured. From five cents a drink to
     15 cents a drink would generate an estimated $72 million. [L – Ortiz y Pino
     was interested.]
3.   Use part of any uncompensated care savings to pay for the health insurance
     of low-income populations after the insurance options are implemented (e.g.,
     ME model). [L, B & R – Heaton likely interested]
4.   Assure that individuals and employers participate appropriately in the cost
     of insurance made available through these recommendations (e.g.,
     appropriate co-pays, premiums based on income, mandates, etc.).
5.   Maximize federal revenue through use of Medicaid for low-income and
     targeted populations. [B & R – Feldman, Trujillo, Picraux]
6.   Repeal GRT exemption on “junk” food

                                                                                      8
                   Insure New Mexico! Council – NEW POSSIBILITIES



1.   Market-Based Universal Coverage
     www.nmhealthchoices.org [L & B – 2007]
        Mandates on employers and individuals
        State role in collecting funds and providing vouchers
        Voucher amount depends on income and health status
        Vouchers used to purchase private sector insurance


2.   Mandates or Encouragement to Provide Wellness Benefits

3.   “WalMart Mandates” for Large Employers


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