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UNM Care transition extended


A slower-than-expected pace of Medicaid enrollments has prompted University of New Mexico Hospital to extend at least until December a health benefit program that served about 26,000 people last year, a UNMH official said.

In October, UNMH officials said they had set a target of late March for moving UNM Care patients into either Medicaid or an insurance plan, but were prepared to extend the transition period to give people time to enroll in the new plans.

UNM Care is a financial assistance program for low-income Bernalillo County residents.

The program’s cost, funded from UNMH general funds, was $131 million in 2013, according to a UNMH audit. Enrollees are required to pay co-payment for clinic visits, prescriptions and procedures.

The hospital anticipated last year that the state’s expanded Medicaid coverage would absorb about 75 percent, or 19,000, UNM Care patients. The remainder were expected to purchase insurance through the state’s insurance exchange.

About 6,200 UNM Care patients, or about 24 percent, had signed up for Medicaid, said Rodney McNease, UNMH’s executive director of behavioral health finance.

“We thought by now we’d be a whole lot further along with Medicaid and the (insurance) exchange,” McNease said recently. “Everything is still in a good bit of flux.”

A big unknown is the number of Medicaid applications that have yet to be processed by the state Human Services Department, where a large volume of applications has created a backlog, he said.

State officials acknowledge they are slammed by thousands of new applications.

“We still believe that about 75 percent of UNM Care folks will qualify for Medicaid,” McNease said. That estimate is based on income data UNMH collects when it enrolls patients for UNM Care, he said.

Under the new Medicaid guidelines, an adult with two children can qualify for Medicaid with earnings of about $27,300 a year, or 138 percent of the federal poverty level. About 75 percent of UNM Care patients have incomes that meet that qualification, McNease said.

Another unknown is the number of UNM Care patients who have applied to buy health insurance through the state insurance exchange, McNease said. That number is expected to emerge as patients seek treatment and present their new insurance coverage, he said.

A total of 26,412 New Mexicans had enrolled in health plans through the state insurance exchange by the March 31 enrollment deadline, the state office of the Superintendent of Insurance said in a news release issued recently.

An additional 10,000 applications had been submitted by the deadline but remained unprocessed, the statement said.

There is no deadline for enrolling in Medicaid.

An estimated 107,000 New Mexicans have enrolled in Medicaid since the state expanded the qualifications in October to include low-income adults, state Human Services Department spokesman Matt Kennicott said Monday.

The Medicaid expansion was provided for under the federal Affordable Care Act, or Obamacare. The federal government initially is covering the cost of health care for those who enroll.

Previously, Medicaid mainly served children from low-income families, pregnant women, elderly adults in nursing homes and some disabled people. Medicaid is a state- and federally-funded health insurance program for the poor.

The expansion brings total state enrollment in Medicaid to 632,000, he said, or about 30 percent of the state’s population.

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Categories: Medicaid Watch