Posted: Saturday, June 15, 2013 11:00 pm -
Showing uninsured New Mexicans how to buy health insurance is essential to making health care available to all.
We live in a rural, far-flung state. Letting people know that health care is available and showing them how to sign up won’t be as easy as running advertisements on an Albuquerque TV station. Especially given that on remote Indian reservations or in Northern New Mexico villages or along the border, people tend to want to talk in person. They like the issues explained to them by someone they know and trust, not a stranger’s voice emanating from the television or radio. For the Affordable Care Act to work in New Mexico, it’s essential that the state gets folks signed up.
That’s why a recent report by New Mexico In Depth, a journalism nonprofit, raises red flags. Reporter Bryant Furlow, in a story published in today’s Santa Fe New Mexican, details how a grant for $20 million in federal funding was moved from the state’s independent Department of Insurance to the New Mexico Human Services Department just a few days before the application was due.
The initial request from state Superintendent of Insurance John Franchini described both regulatory oversight and the enrollment process in New Mexico’s health exchange — the place where people will be able to go online and find the policy that works for them. But the final application — which came out of Human Services — lacks those sections. The new grant application went in on the deadline, May 15, with Washington approval still pending. The state definitely needs the money, considering New Mexico has one of the highest rates of people without health coverage in the nation.
Some changes that advocates point out could be a matter of semantics — words were replaced, enrollment with marketing, for example. But words do have singular meanings. Enrollment indicates a more individual process, with the end result being that a person signs up for health insurance. Marketing is more a mass endeavor. Think of radio or television advertisements spreading the word and raising awareness. But awareness doesn’t always translate into action, and for health reform to work, we need action; that is, people need to purchase insurance.
Human Services Department officials say enrolling people is a part of the marketing effort. Perhaps so, but we urge health care reform advocates and others to keep watching this process. This $20 million (if New Mexico receives the grant) shouldn’t be frittered away on contracts to connected public relations people when on-the-ground forces are needed to get out to the Navajo Nation or the border. After all, in some parts of the state, many lack computers, or Internet reception is hit or miss. What good is an online exchange? TV reception can be spotty or nonexistent except for people who can afford satellite services, and many can’t. Marketing outreach that would work fine in Albuquerque or Santa Fe (and even there, a personal approach might work better in Albuquerque’s South Valley or along Hopewell Street, for example) won’t succeed elsewhere.
What’s even more insightful in the New Mexico In Depth report is the back and forth between agencies. Insurance Superintendent Franchini’s draft request mentioned streamlining the state’s Medicaid and health insurance marketplace computer systems so that applying for insurance is easier. That’s not required by the Affordable Care Act, but it certainly makes sense. Imagine, one place for a busy, single parent to find out whether the family qualifies for Medicaid or help in buying a policy in the health insurance marketplace. Whoever is in charge, that’s a common-sense policy. However, Human Services officials felt that such decisions did belong in the grant application, but fell under their purview. Rather than squabbling over turf, we hope Human Services Department Secretary Sidonie Squier concentrates on what makes sense. Grab the best of Franchini’s ideas and put them in place through another mechanism.
Eventually, the New Mexico Health Exchange Board will be in charge of the whole shebang — Squier has said she will turn over the $34 million grant to set up the exchange once the board is up and running; it will control the $20 million outreach grant, if awarded, as well.
Everyone involved must remember that for the exchanges to work and for health care reform to become affordable, as many people as possible must enroll. The more people in, the less of a risk it is for everyone, especially when young and healthy people join the pool. The more people in, the fewer uninsured sick people showing up at hospitals, costing taxpayers millions. The more people in, the closer we are to a society where people can receive the medical care they need and deserve. That’s the goal to keep in mind.