“I think it’s inhumane and mean-spirited,” said one man who called in to participate in the hearing by telephone.
State officials, in turn, told the audience of about 60 that the proposal would encourage patients to seek preventive services, help control costs and improve the coordination of care received by Medicaid recipients. They said they were open to making changes based on the public comments.
The proposed changes, in any case, must be approved by the federal government. They would go into effect in 2019 if approved.
Medicaid covers more than 40 percent of the population in New Mexico, providing services to low-income individuals and families and people with disabilities.
Opponents said the introduction of premiums and expanded copays – however small – would discourage people from seeking coverage, even if there are exemptions. They also said the proposal would eliminate important benefits, such as transitional and retroactive coverage.
“When in doubt, people who are struggling financially are going to say, ‘I don’t have $10. I can’t go to the doctor and risk having to pay this,’ ” said Elena Rubinfeld, staff attorney at the Southwest Women’s Law Center.
Monday’s two-hour hearing, held at the National Hispanic Cultural Center, was the last in a round of public meetings this month focusing on the proposal.
The proposed changes come as New Mexico faces a tight budget. Lawmakers heard just last week that Medicaid costs could climb about $82 million next year, partly as a result of changes in federal funding.
Under the proposal, the state would:
• Charge premiums for the first time. People and families below the federal poverty line – about $12,000 for an individual – would be exempt, as would Native Americans.
The amount charged would depend on the patients’ income, starting at $10 a month for an individual just above the poverty level, with a state option to push it to $20 a month in future years. Households with more than one person would pay twice the basic premium.
• Introduce more copays into the system. Individuals above the poverty level, for example, would face new copay requirements, such as $5 for some office visits and $2 for prescriptions.
Most Medicaid patients would also have to pay $8 for medication if they opt for the brand-name drug when a generic is available or if they visit an emergency room when they don’t have an emergency.
There would be a variety of exemptions.