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#GivingTuesday

 

Click here to make a donation directly to Health Action New Mexico's work.

December 1st is Giving Tuesday – a campaign to create a national day of giving at the start of the annual holiday season.  It celebrates and encourages charitable activities that support non-profit organizations like Health Action New Mexico.

Today we invite you to pause and consider supporting Health Action New Mexico on the kickoff of Giving Tuesday as we work to increase access to oral health care and connect our New Mexico families to affordable to health care.  

Please support Health Action New Mexico.  Our goal is to raise additional funding for consumer outreach to the hardest to reach communities-including families in New Mexico’s border region.  We make sure consumers, their concerns and needs are at the table in campaigns like the consumer-led movement to expand access and affordability of dental care and expanding health coverage to all people in New Mexico.

With your help we know we can get there.  Please share this link via email or on you social media with the hash tag to spread the word about this wonderful day and our important work to increase access to affordable health are.

 

Best wishes during this holiday season,
Health Action New Mexico

 

              

www.HealthActionNM.org 

Health Action

New Mexico’s health insurance co-op is strong, despite national trends

After a key market stabilization payments came in lower than expected, non-profit health insurance co-ops around the nation began to close shop.  Fortunately for New Mexico, our co-op, New Mexico Health Connections (NMHC), remains financially solvent and is considered to be one of the strongest health insurance co-ops in the nation.  In fact, its financial solvency is four times higher than is required by the state’s insurance department.

NMHC’s role is especially important this year, as Blue Cross Blue Shield exits the market.  The co-op is building its network of providers rapidly to ensure that consumers can retain their doctors during this transition.  Nearly 7,750 providers now accept the carrier’s insurance and the number is growing every day.  According to the co-op, providers are coming to them and asking to be contracted so they can continue to see their patients.  This is a positive development for the state and will hopefully lead to savings for consumers.

Due to a filing error, NMHC’s plans will not be featured on beWellnm until November 15th.  The plans can be viewed here in the meantime.  Because of this error, many news outlets incorrectly reported that premiums rose by 26% in New Mexico.  The Office of the Superintendent of Insurance has corrected this error and noted that plans have only risen by 7.5%.

Note: Health Action NM does not endorse any insurance carrier or their products. This should not be interpreted as an endorsement of NMHC and is only intended to inform consumers about the state's co-op in light of recent national trends.

Health Action

Everything you need to know about the Open Enrollment period starting November 1

The open enrollment period for purchasing individual or family coverage through BeWellNM has arrived!  Beginning November 1, 2015 www.bewellnm.com will be open for those seeking health coverage.  The enrollment period is only three months long, ending January 31, 2016.  Here are some important things to keep in mind if you intend to purchase or renew coverage:

Before shopping on the exchange, see if you are eligible for Medicaid

You can visit https://www.yes.state.nm.us to sign up for Medicaid.  Be sure to seek out free enrollment assistance if you want help with your application by calling Health Action New Mexico at (505) 322-2152. 

Medicaid is a health coverage program that provides cost-free insurance to low income Americans.  Individuals making less than about $16,105 a year and families of four making less than about $32,913 a year are eligible for Medicaid.  Medicaid is available throughout the year, unlike plans acquired on the exchange, which can only be purchased during the open enrollment period.  If you are 1) between the ages 19-64 and 2) are a U.S. citizen or lawfully present immigrant and meet household income requirements, you may be eligible for free health insurance.

 

You can also use the chart below to see whether you and your family qualify for Medicaid:

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Health Coverage and Financial Help

If you don’t qualify for Medicaid, the next step is to visit http://www.bewellnm.com, where you can shop for health coverage.  It is important to keep in mind that the window for obtaining coverage through the exchange is limited, lasting from November 1, 2015 to January 31, 2016. 

You may be eligible for financial help.  You will need to know your household income to determine your eligibility.  Check out the Get Covered subsidy calculator to see how much you can save on your health plan. Right now, you can view price estimates for plans that you can purchase that factor in tax credits at https://www.healthcare.gov/see-plans/.  Insurance lingo can often be confusing.  If you run in to any terminology that you are unfamiliar with, check out beWellNM’s health care glossary.  You can always call Health Action NM’s office if you have any questions.

Shopping for insurance can be a daunting task.  Luckily there are experts available to help you find the plan that is right for you. Health Action New Mexico can connect you to a trusted local assister near you.  Click here or call our office at (505) 322-2152 and we will help you arrange a free appointment.  BeWellnm is setting up enrollment sites throughout the state.  Right now, you can visit the Enrollment Assistance Center at 2301 San Pedro NE near Indian School in Albuquerque.  Check back on this post for updates on enrollment sites in other parts of the state.

Shop around before renewing your health plan

If you purchased a plan on the exchange last year then you will be re-enrolled in to the same plan for 2015 unless your insurance company stops offering your plan or you choose to purchase a new plan.  If you like the coverage you received you should still be sure to review your plan before renewing it, as the premiums, co-pays, and other aspects of your plan’s cost may have changed.  In other words, you may pay more than you did last year for the same plan, so be sure to review your plan and shop around.  There may also be new plans offered on beWellnm that are more affordable or better suit you and your family’s needs.

Sign up by December 15th if you want your coverage to start January 1st

While the enrollment period lasts through February 15th, you can start using your coverage at the beginning of 2015 if you sign up by December 15th.  If you wait until the end of the enrollment period to sign up for coverage, your insurance will kick in on March 1st, 2016.

The penalty for lacking insurance is higher than it was last year

If you don’t obtain some form of health coverage, you may have to pay a shared responsibility fee.  The penalty was the greater of $325 per adult or 2% of income in 2015.  This year the penalty has increased to the greater of $695 per adult or 2.5% of income.  You can avoid the penalty by enrolling in health coverage.

A hardship exemption exists for those who truly cannot afford insurance.  To see if you qualify for a hardship exemption, visit https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.

Health Action

The Benefits of Shopping on beWellnm.com

Finding a health insurance plan that’s right for you and your family is now easier and more affordable. Starting November 1, people all over New Mexico can sign up for coverage on beWellnm.com.

 

BeWellNM is a health insurance marketplace that offers:

  • financial help to reduce monthly premiums and the cost of seeing your doctor;
  • free enrollment assistance;
  • shopping tools that make it easy to find the right plan; and
  • robust competition to drive down premiums.  

Anyone who is currently uninsured or previously enrolled in a plan through the marketplace should visit beWellnm to check out their options. Plans and prices change every year, so you should shop around and make sure you’re finding the one that’s right for you.  Here is what you need to know about the beWellnm marketplace.

Protect yourself from the Unexpected

An accident or injury can happen any day. When it does, the last thing you should have to worry about is how to pay for your health care or taking on medical debt. On beWellnm, you can find a plan that keeps you covered, no matter what life throws at you.  All beWellnm plans cover doctor visits, hospital stays, prescriptions, preventive care and more.

Financial Help is Available

BeWellnm.com is the only place where you can get financial help to reduce the cost of coverage. Nearly three out of four New Mexicans enrolled in plans on beWellnm currently receive tax credits averaging $196 per month. That would be like completely eliminating your phone bill!  

You may also be eligible for financial help to reduce your out-of-pocket expenses.

Even if you’re already enrolled, you should check out your options to make sure you’re taking advantage of the financial help that is available and getting the best deal possible.  

Free Enrollment Assistance

BeWellNM.com offers free enrollment assistance to answer your questions and help walk you through the enrollment process.  To connect with an enrollment assister in your area, call Health Action New Mexico at (505) 322-2152.

Transparent Shopping Tools

Tools on beWellnm make the enrollment experience much easier for consumers.  The website calculates your tax credits and cost sharing reductions for you, allows you to compare plans side-by-side, features a map and list of providers who accept your insurance, and much more. This type of transparency gives you the peace of mind from knowing that you made a smart choice and isn’t often available through other health insurance websites.

More Competition = Lower Prices

A recent study found that plans sold on beWellnm and similar marketplaces in other states are more affordable for consumers, even without financial help.  BeWellNM has some of the lowest premiums in the nation and with tax credits those premiums are even lower.  That’s why, come November 1, beWellnm.com is the place to shop for affordable health coverage!

Want to know more? Over the next several weeks, Health Action New Mexico will be posting blogs that provide you with everything you need to know about the marketplace including real stories from consumers that received coverage through beWellnm. Stay tuned!

 

Health Action

October Newsletter

 

Thanks to all who made Health Action New Mexico’s 20th Anniversary such a special occasion.  It was such a joy to see the advocacy community together in one place to celebrate the spirit of the work we all do.  We would like to thank AARP of New Mexico, Delta Consulting, New Mexico Health Connections, and Presbyterian Health Plan for sponsoring the event.  

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Health Action NM's Board of Directors and Staff with Ron Pollack (Families USA)
 

20th Anniversary Video Produced by Blackout Theatre Company

Photographs by JAK Media

Congratulations from US Senator Tom Udall

Video Message from Retired US Senator Jeff Bingaman

Event Program 

healthactionanniversary-110.jpg

 

The Next Step in Health Reform

The expansion of health coverage has been nothing short of remarkable.  Nearly 300,000 people have gained access to health coverage as a result of the Affordable Care Act.  As we help newly insured consumers navigate the health care system and use their coverage we must also turn our sights towards the quality of health care in New Mexico.

The New Mexico Department of Health and New Mexico Human Services Department have undertaken the enormous task of developing a strategy to achieve better health outcomes by innovating our health care delivery system.  Health Action New Mexico is garnering consumer input on the current draft of the state’s plan, which includes reforming how we pay doctors to incentivize keeping patients healthy, addressing the social determinants of health, and integrating behavioral and oral health in to primary care, among many other initiatives.  Health Action New Mexico looks forward to contributing to this monumental step towards a more patient and consumer oriented health care system.

 

Consumer Alerts: Open Enrollment Begins November 1st

The next window of time to purchase health coverage is just around the corner!  On November 1st, 2015 beWellNM.com will be open for shopping.  The open enrollment period ends on January 31st, 2016.  Advocates should take a look at Health Action New Mexico’s Private Market Enrollment Report to see the state of enrollment in our state.  

Here are 5 things for consumers to keep in mind: 

1) If you currently have a marketplace plan, it will remain active until the end of the year.

2) If you want your new coverage to kick in by January 1st, 2016 you need to sign up by December 15th, 2015.

3) The New Mexico Health Insurance Exchange (bewellnm.com or healthcare.gov) is the only marketplace where you can access premium tax credits and cost sharing reductions.

4) Even if you like your current plan, you should shop around to see if there is a more affordable plan or a plan that better meets your needs.

5) The shared responsibility penalty for lacking coverage in 2016 raises to the higher of $695 per person or 2.5% of income but the best reason to get covered is to keep you and your family healthy.

Blue Cross Blue Shield dropped out of the exchange for 2016 and New Mexico Health Connections dropped several plans.  If your 2015 plan is no longer available, the Office of the Superintendent of Insurance (OSI) is mobilizing a statewide roadshow to help consumers find plans that work for them. Click here to see when they will be in a town near you.

 

Dental Therapist Task Force

On October 2nd, Health Action New Mexico staff participated in the third in a series of four meetings in which the New Mexico Dental Hygienist Association panel, that includes Health Action New Mexico, and legislators, will again meet the New Mexico Dental Association panel with hopes of coming together to draft meaningful, effective dental therapist legislation for New Mexico.  It is not clear whether consensus will be achieved. Dental therapist supporters including dentists, hygienists, educators and community leaders have observed the task force meetings and are invited to attend the fourth meeting.  The date for the next task force meeting is yet to be determined and will be later this month or in early November.

 

From the Field

Victor Montoya and Joe Martinez are working in the Colonias and border areas to help people in those communities engage their neighbors in getting covered and finding ways to access care. “Without accessible health care coverage and services only prisons and poverty will flourish in the Colonias of New Mexico,” Last month, the outreach team also worked with our board president Erik Lujan to train advocates, nurses, and state employees in northern New Mexico on how to enroll individuals in Medicaid and the exchange.

Nohemy Bojorquez-Flores is gearing up for the open enrollment period and gathering stories from her community. “Open enrollment is just around the corner,” says Nohemy.  “I am reaching out to the community and keeping them informed!”

On October 15th and 16th from 9 AM to 5 PM, Health Action New Mexico hosted a free outreach workshop on health coverage with Enroll America at the Friends Meeting House.  An incredible group of advocates came together to craft our strategy for the upcoming open enrollment period.

Health Action

Rate Review: Ensuring Affordability through Accountability

Rate Review: Ensuring Affordability through Accountability

For decades, health insurance premiums skyrocketed alongside insurance industry profits. Left without a way to challenge these arbitrary hikes, consumers were stuck with larger bills without seeing improvements to their coverage.  But, recently, state and national health reform initiatives have placed more power in the hands of consumers, creating new tools to hold insurance companies accountable.  Rate review is one of those tools.

What is rate review?

Rate review is a process that requires insurance companies to open their books to ensure that they provide “accurate, verifiable data and realistic projections of health costs,” according to the nonpartisan Kaiser Family Foundation.  Health Action New Mexico and our partner organizations worked to establish a rate review process to protect consumers and hold insurance companies accountable for unfair health care premium rate increases.  The state enacted legislation on rate review in 2011.  Now insurance companies have to justify rates with data and the state has to make these proposed increases public.  Rate review works because it brings consumers into a process that was once conducted behind closed doors. It uses accountability to ensure affordability.

How does rate review work?

Insurance carriers must submit proposed rate increases to the New Mexico Office of the Superintendent of Insurance (OSI).  OSI posts those rates on its website, where consumers can submit comments on the increases.  Formal hearings can then be brought forth by consumers.  Once OSI has heard from consumers and insurance carriers, it looks at each company’s financial data to determine whether the requests are valid.  If a proposed rate is found to be backed by the evidence, the carrier must alter its proposal to an acceptable rate that matches the available data within 30 days.

How has rate review affected premiums?

In many states, final rates are lower than proposed rates thanks to the rate review process.  Kaiser Family Foundation recently found that rate review brought down overall rates across the state.  Looking specifically at Albuquerque’s benchmark plan, the process directly reduced an increase in rates from 11 percent to 7 percent, saving money for consumers.

  

What’s the story with Blue Cross Blue Shield?

In June of 2015, Blue Cross Blue Shield (BCBS) of New Mexico proposed a whopping 51 percent rate increase.  The request stunned consumers, the media, OSI - just about everybody.  BCBS claimed that their customers required more expensive care than those enrolled in plans with other carriers.  However, after carefully reviewing consumer feedback and BCBS’s financial information, OSI determined that the rate hike was far beyond justification.

The rates that BCBS chose to submit weren’t supported by the data the company provided. While OSI supported an increase of 24 percent – the highest among all carriers in the marketplace –  BCBS refused to cooperate and, instead, dropped out of the market for 2016.  This means thousands of consumers will need to find new coverage options in the health care marketplace.  Fortunately, other insurance carriers are working to expand their networks to cover providers throughout the state.

What should I do if my BCBS plan is no longer available?

The first thing to keep in mind is that your current plan will remain active until January 1st, 2016.  You have between November 1st and December 15th to sign up for a new plan that kicks in on January 1st. Four other insurance carriers offer plans on BeWellNM: New Mexico Health Connections, Molina, Presbyterian, and Christus St. Vincent.  There will be 35 plans to choose from on BeWellNM, which is the only marketplace where financial help is available.  OSI is also mobilizing a consumer roadshow to help those affected by BCBS’s exit from the marketplace.  Click here to see when they are in a town near you.

BCBS does have a plan available but it will not be sold on BeWellNM and financial help will not be available.  It is also a “Bronze” plan, meaning that it offers weak coverage with high out-of-pocket costs.  Consumers should shop around on the exchange to find a plan that best meets their needs.

How can I get involved in rate review?

The next rate review process begins in the summer of 2016, when insurance carriers propose rates for 2017.  Health Action New Mexico will be actively ensuring that consumers are representated as OSI considers the new rates.  Submit your story to colin@healthactionnm.org if you think your premiums are being unfairly raised.  Also be sure to submit comments to OSI next summer on this page.  If you would like to request a hearing, call Health Action New Mexico and we will discuss the arrangements that need to be made to do so.  Our number is (505) 322-2152.  

Health Action

Centennial Care: Health Insurance for Working New Mexico Residents

New Mexico Study: Working Individuals Make Up the Largest Group Who Benefit from Medicaid Expansion 

Study Estimates that 56 Percent of those benefiting from New Mexico’s Medicaid Expansion are Working Adults in Key Economic Sectors

More than 90,000 New Mexicans benefiting from the state’s decision to accept Medicaid expansion work in industries that are the foundation of the state’s economy, with jobs ranging from sales and food service to construction and health care, according to estimates in a study released today by Families USA. 

This projected group of working New Mexicans represents an estimated 56 percent of the state’s residents who benefit from New Mexico’s Medicaid expansion, which went into effect last year. 

“These statistics are an important part of the story about Medicaid in New Mexico,” said Barbara Webber, Executive Director of Health Action NM, a non-profit health consumer advocacy organization based in Albuquerque, NM. “We are thrilled that Centennial Care, including the very important Medicaid expansion for adults in our state, has contributed to the significant increase in health coverage for hard working families.  

“This improved health access will certainly mean better health status for working families and increased productivity for the industries they represent,” Webber said. “This proves that Medicaid has been a win-win situation for New Mexico.”

Without Medicaid expansion, many of these people would have fallen through the cracks in the health care system – making too much for traditional Medicaid, but too little to qualify for subsidies on the insurance exchange, said Ron Pollack, executive director of Families USA.

“This study shows Medicaid expansion is a success story in New Mexico,” Pollack said. “The people it helps have tough jobs in industries that traditionally don’t provide health insurance. Now after a hard day’s work, they can sleep with the peace of mind that health insurance provides – knowing that a sudden accident or illness won’t wipe out their savings and dreams for the future.” 

“Governor Martinez should be congratulated for her initial decision to expand Medicaid,” Pollack said. “The numbers contained in this study show how important this program is for so many of the working people of her state.”

Under Medicaid expansion, which went into effect in 2014, states can offer Medicaid coverage to residents with incomes up to 138 percent of the federal poverty level, which is $27,720 for a family of three. For the first three years, the federal government pays 100 percent of the costs. Starting in 2017, states will begin paying a small portion of the costs, which will be capped at 10 percent in 2020.

Health Action

Meet Ron Pollack, a National Health Advocate

Ron Pollack, Executive Director of
Families USA and alleged "whipper-snapper"

 

We are honored to announce that the keynote address at Health Action NM's 20th Anniversary Celebration Dinner will be presented by a national leader in consumer health advocacy, Mr. Ron Pollack, Founder and Executive Director of Families USA.  Mr. Pollack has been recognized for many achievements, which include being appointed by President Clinton as the sole consumer representative on the Presidential Advisory Commission on Consumer Protection and Quality in the Health Care Industry, successfully arguing two cases on the same day in the U.S. Supreme Court to secure food aid for low-income Americans, and the successful federal litigation that resulted in the creation of the WIC program for malnourished mothers and infants.  He was also instrumental in the creation of Health Action NM.

How it all started

Health Action NM’s roots lie in the reaction to proposals that would dismantle the social safety net in the United States.  In the mid-90’s, there was a serious effort to severely cut and privatize Medicare and Medicaid, monumental programs that effectively provide financial security and access to health care for millions of Americans.  A grassroots movement formed throughout the nation to protect these programs during this time of great uncertainty.  Central to this effort was Ron Pollack, who was called “a real whipper-snapper” by Mandy Pino, one of Health Action NM’s founders.

Building a movement

Throughout the nation, Mr. Pollack organized advocates to oppose efforts to weaken or eliminate public health coverage programs.  Among the advocates were three New Mexicans: Mandy Pino, Pat Bartels, and Ellen Leitzer.  Together, they formed the Committee to Preserve Medicare and Medicaid. “Families USA identified or created small groups throughout the nation to protect these programs” says Pino, “and that’s how Health Action NM started.”  For the first several years, the committee worked on a completely volunteer basis to advocate at the local and national level to protect essential programs and create new protections for patients and consumers. That committee eventually became Health Action NM and spurred the creation of the New Mexico Health Care for All Coalition.

From organizing to action
By the late 1990’s, Health Action NM was officially formed and brought together community activists and policy experts to advocate for better health care policies.  Community forums were held throughout the state to bring consumer testimony directly to state officials.  In 1998, Ellen Pinnes was hired as Health Action NM’s first official paid staffer and worked with Jim Jackson and other co-chairs to pass the Patient Protection Act, a historic patient bill of rights that was passed by the state legislature.  These advocates also worked to create a community foundation with funds from the conversion of the Blue Cross/Blue Shield New Mexico in to a for-profit entity.  In 2002, that foundation became the Con Alma Foundation, which now distributes in excess of $1 million annually to community-based health care organizations.  The organization then worked to develop a blueprint to improve New Mexico’s health care system for the next several years.

National health reform
During the debate around health reform, Health Action NM engaged communities around to state to educate people about the most promising ideas in health policy.  Upon the passage of the Affordable Care Act, our staff worked tirelessly to advocate for policies that the state could adopt to better serve people in New Mexico during the law’s implementation. Working alongside incredible partner organizations, Health Action NM advocated for and secured the expansion of Medicaid, the creation of the New Mexico Health Insurance Exchange, and a process to review and reject unjustified health insurance premium hikes.  By 2013, Health Action NM assembled a statewide field team in conjunction with local partnerships to organize outreach and enrollment efforts. 

20 more years of success
It is incredible to look back at all of the stories, people, and places that went in to creating this organization.  Our team couldn’t be more thrilled to honor those who have made such a substantial impact on our state’s health care system for the good of the people.  We hope you will join us in celebrating 20 years of advocating for consumers, increasing access to health care, and engaging with communities in New Mexico in their own health.  We’re looking forward to 20 more.  Cheers!

Health Action

Celebrating 20 Years of Health Action in New Mexico

  

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Click here to reserve tickets for our 20th Anniversary Celebration.

Health Action NM has worked for 20 years to bring organizations, consumers and decision-makers together to impact health policy and to advance access to quality, affordable and accountable health and dental care for all.  Now, it is time to celebrate those achievements and look forward to the next 20 years of advocacy.  We are excited to announce that tickets and tables are now available for Health Action NM’s 20th Anniversary Celebration on September 26th at the Sheraton Albuquerque Uptown.  Be sure to reserve your tickets before they run out! If you can’t make it to the event, you can click here to donate to Health Action NM. Our celebration, which will feature Nicole Brady as the MC, will include live music and a dinner.  

  

The keynote address will be presented by a national leader in consumer health advocacy, Mr. Ron Pollack, Founder and Executive Director of Families USA.  Mr. Pollack has been recognized for many achievements, which include being appointed by President Clinton as the sole consumer representative on the Presidential Advisory Commission on Consumer Protection and Quality in the Health Care Industry, successfully arguing two cases on the same day in the U.S. Supreme Court to secure food aid for low-income Americans, and the successful federal litigation that resulted in the creation of the WIC program for malnourished mothers and infants.  He was also instrumental in the creation of Health Action NM.

  

We are equally excited to announce that we will be honoring 20 individuals who have made major contributions to improving health care in New Mexico over the past 20 years. Sitting members of the state legislature were not included in our consideration, though many have played key roles in advancing the health care system in New Mexico.

Health Action NM’s 20-for-20 Honorees

Charlie Alfero

Director of the Center of Health Innovations, Founder of Hidalgo Medical Services 

Sanjeev Arora, MD

Founder and Director of Project ECHO, a telemedicine model that has been utilized worldwide

Pat Bartels

Co-Founder Health Action New Mexico, Former President of the New Mexico Chapter of the American Physical Therapy Association

Notah Begay III

4-time PGA TOUR winner, Founder NB3 Foundation, the only national Native American nonprofit organization solely dedicated to reversing Native American childhood obesity and type-2 diabetes.

J.R. Damron, MD

Board Chair, New Mexico Health Insurance Exchange and healthcare reform visionary

Hon. Dede Feldman

Retired New Mexico State Senator, Former Co-Chair of the New Mexico Legislative Health and Human Services Committee

Teresa Gomez

Director, NM Futures for Children, Chair of the Gynecological Cancer Awareness Project, Board Member, New Mexico Health Insurance Exchange, Board Member New Mexico Medical Insurance Pool

Jerry Harrison, PhD

Director, New Mexico Health Resources and the New Mexico Health Policy Commission

Ruth Hoffman

Director, Lutheran Advocacy Ministry New Mexico

Jim Jackson

Director of New Mexico Disability Rights, Former Health Action New Mexico Board Chair

Bill Jordan

Policy Director, New Mexico Voices for Children

Richard Kozoll, MD
Primary care physician and community leader in Cuba, New Mexico and White House Champion of Change awardee

Ellen Leitzer, JD

Co-Founder of the Senior Citizens Law Office, Co-Founder Health Action New Mexico

Patricia Montoya, MPA, BSN

Executive Director of the Albuquerque Coalition for Healthcare Value, Government Relations for Health Insight New Mexico, Former New Mexico Secretary of Health

Ellen Pinnes, JD

Former HANM Staff Member and Advocate with New Mexico Disability Coalition

Harriet “Mandy” Pino

Co-Founder Health Action New Mexico, Former Manager of Senior Information Services at the Albuquerque Office of Senior Affairs

Kim Posich, JD

Executive Director, New Mexico Center on Law & Poverty

Patsy Romero

COO of Easter Seals, Board Member, New Mexico Health Insurance Exchange

Dolores E. Roybal

Executive Director, Con Alma Health Foundation

Silvia Sierra, MS

President of Cultivating Communities, Former Director Doña Ana County Health and Human Services

Posthumous Awardees

Patricia “Patty” K. Jennings

Founder, New Mexico Medical Insurance High-Risk Pool

June Werner, RN

Former Health Action New Mexico Board Chairman

 
 
   
  
Health Action

What We're Reading This Week: Senator Dede Feldman's Speech on Medicare and Medicaid

This week instead of reviewing stories, we have decided to post the remarks prepared by former State Senator Dede Feldman in regards to the 50th Anniversary of Medicare and Medicaid.  The remarks were presented at the Health Care for All Coalition's Medicare and Medicaid celebration on July 30th, 2015.   They provide an encapsulating view of the history of health coverage expansion, the challenges of acheiving full universal coverage, and the path towards that goal.  We hope you enjoy her brilliant insights as much as we do.

Former State Senator Dede Feldman
 
 

Thank you to the New Mexico Health Care for All Coalition. What a great pleasure it is to be with you here today, as we celebrate the anniversary of Medicare and Medicaid. Since I left the legislature a few years ago, more and more I find myself mulling over the historical and social context of what happens in Santa Fe and Washington. So in that vein, I ask you to take a little stroll down memory lane with me…. Starting with 1964, the year before Congress passed Medicare. The average price of a new house was about $13,000; a postage stamp was 5 cents; and a loaf of bread a quarter.  Congress passed the Golf of Tonkin resolution and the war in Vietnam was heating up.  There was historic Civil Rights legislation, and it was the year the Beatles invaded the US.

I was a senior in high school that year, and on the debate team.  The national question was “Resolved that social security benefits should be extended to medical care for Americans over 65.” I remember vividly the debates, the note cards I meticulously compiled pro and con.  It was easy to assemble the con position form the huge number of TV and radio ads, the white papers put out by the AMA, all warning of a soviet style model of medical care. They were the same warnings of rationing, of socialism, of the dangers of some health authority dictating the terms of the most intimate areas of American life that I heard 40 years later in the legislature as I pushed for more health care coverage—by any means necessary.  

 

Here are a few of the clips from that time:

Ronald Reagan: “[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” [1961]

Barry Goldwater: “Having given our pensioners their medical care in kind, why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink.” [1964]

 

The passage of Medicare in 1965 was not an isolated event. It was the culmination of over a half-century of work, by people who believed in universal health insurance, starting with Teddy Roosevelt and the Bull Moose Party in the early 1900s, FDR who shelved it to get social security, and especially Harry Truman who sent Congress its first comprehensive proposal. 

It was Harry Truman that President Lyndon Johnson honored fifty years ago today when he traveled to Independence Missouri to sign the Medicare bill. One person who was at his side was New Mexico Senator Clinton Anderson, who played a key role in the early ‘60s.  Anderson sponsored a Medicare bill in 1962.  It was a key priority of the newly elected president, John F. Kennedy, but it was defeated by two votes in the Senate after a barrage TV and radio ads of phone calls and the first “Astroturf” campaign of canned letters to congress drummed up by the AMA.  But the tide of public opinion was turning. Proponents continued to struggle for it in Congress. In1964, two separate bills passed both the House and the Senate.  But the conference committee was not able to agree—I hope you’re seeing some parallels with the Affordable Care Act here—and so the measure died, again.

But after Lyndon Johnson received 60% of the vote in the fall of 1964, and Goldwater was defeated, the handwriting was on the wall.  This time, in 1965, the conference committee’s report was adopted on July 27 and 28th. And the rest is history.

But it’s a different kind of history than those legendary lawmakers would have expected.  Now Medicare and Medicaid are not social insurance programs, strictly run out of Washington.  They are largely private programs, run by insurance companies and the states, the subjects of constant financial worry and political pressure.

Of course, the authors of Medicare, and later, Medicaid did know what health care reformers today have learned, with the passage of the Affordable Care Act and other reforms.    That each victory is part of a progression of smaller steps, one building upon one another.  Sometimes in the slow process, it seems like we are going backward, exerting all our efforts just to prevent the dismantling of what those policy makers gathered in Missouri staked their reputations, their positions, and the efforts of a lifetime on.

 But in the ensuing twenty years we have built on their efforts, starting the Children’s Insurance Program, most recently expanding Medicaid to 800,000 recipients in New Mexico, adding a drug benefit to Medicare, imperfect as it is, and passing the Affordable Care Act, which will be celebrated 50 years from now as another giant step along the road to comprehensive and health care coverage. 

We all know that there are many challenges ahead for Medicare and Medicaid—how to bend the cost curve in the face of the onslaught of new baby boomers? How to negotiate for lower prescription drug prices?  How to prevent fraud and abuse? Or streamline the huge Medicaid bureaucracy, which rests on an outdated waiver system that costs states million to prove what they already know is working.  But we also know that the route to reshaping the delivery system, moving away from fee for service, and moving toward a more accountable and equitable system starts with Medicare and Medicaid.

 But today, today shows us, that the arc of history does bend toward justice, toward what Johnson called in the same speech “a triumph of rightness in America.”  So, thank you, it’s great to be a part of this stream of history with you today. 

- Dede Feldman, Former New Mexico State Senator and Author of “Inside the New Mexico Senate: Boots, Suits, and Citizens"

 

 

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