State Government Profile
Governor: Susana Martinez (R)
Lt. Governor: John Sanchez (R)
Attorney General: Gary King (D)
Legislature: Senate (Democratic control 27-15), House (Democratic control 37-33)
Legislative Leaders: Senate President Pro-Tem Timothy Zeph Jennings (D);Speaker of the House Ben Lujan (D)
2012 Legislative Session: Jan. 17 – Feb. 16
Key Health Officials: Superintendent of Insurance John Franchini; Human Services Secretary Kathryn “Katie” Falls; Julie Weinberg, Acting Director, Medical Assistance Division (Medicaid Director)
- Human Services Department (HSD)
- Public Regulation Commission (PRC) Division of Insurance
- Governor’s Office
- State Legislature
State Population: 2,059,179 (2010 US Census data)
Medicaid Enrollment: 546,101 (July 2010, CMS)
Percent Enrolled in Managed Care: 73.12% (July 2010, CMS)
Uninsured Rate: 21.8% (three-year average, 2008-10, US Census Bureau)
Health Reform Projections: 145,024 – 201,855 (total new Medicaid enrollees, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)
2.1 – 3.0% (change in state Medicaid spending, low and high participation scenarios, Kaiser Commission on Medicaid and the Uninsured)
State Fiscal Year (SFY) 2011 Budget Appropriations: $5.424 billion (state general funds)
SFY2012 Projected Budget Shortfall: $410 million (state general funds)
SFY2008 Medicaid Expenditures: $699 million (state general funds)
Federal Medical Assistance Percentage (FMAP) Rates:
72.98% (January – March 2011)
70.98% (April – June 2011)
69.78% (July – September 2011)
69.36% (October 2011 – September 2012)
Health Reform Implementation Activities and Developments
Health Reform Implementation Structure:
In April 2010 Governor Richardson issued an Executive Order establishing the Health Care Reform Leadership Team for the implementation of national health care reform in New Mexico. The Leadership Team is to develop a strategic plan, coordinate across state agencies, and be accountable for recommendations while providing oversight of the planning, development, and implementation of reform. The Leadership Team is chaired by the Secretary of the Human Services Department (HSD) and the HSD has primary responsibility for providing administrative staff and support to the Leadership Team.
In July the Leadership Team delivered their strategic plan, Implementing Health Care Reform – A Roadmap for New Mexico, to Governor Richardson, along with a letter of transmittal highlighting key recommendations such as creating a strong, state-level health insurance exchange. The Governor acted upon several of the initial recommendations including continuing and expanding the Health Care Reform Leadership Team and creating an Office of Health Reform at the Human Services Department.
The legislature adopted Senate Joint Memorial 1, calling on the Public Regulation Commission (PRC) Division of Insurance to convene a health care reform working group (the SJM1 HCRWG) to make recommendations and propose action steps for implementation and for strategies to access federal money. The SJM1 HCRWG gave a presentation on its progress, work plan, and timeline to the HCR Leadership Team in September and issued its final report to Legislature and Governor Richardson in November 2010.
The New Mexico Office of Health Care Reform issued its Transition Plan Document and recommendations to Governor-elect Martinez for the continued implementation of health reform on December 27, 2010.
The HCR Leadership Team held a meeting to gather stakeholder input on the Exchange planning and establishment grant. The SJM1 HCRWG also convened an Exchange Advisory Group.
New Mexico applied for and was awarded an Exchange Planning and Establishment Grant
Amount Awarded: $1,000,000
Administrator: New Mexico Department of Human Services
Initial Planning Activities:
- Fund a financial modeling tool and report, which will identify the population of affected individuals and employers and project the effect of an Exchange(s) on the marketplace, populations of affected individuals, State expenditures and changes in spending by payer.
- Determine the changed distribution of health insurance coverage by payer and the change in health insurance coverage under all of the federal health care reform measures.
- Study and begin to implement the details of implementing the Exchange(s).
- Provide follow-up research and analyses, as suggested by the direction and inquiries made by the Legislature and the incoming Governor.
- Consider a regional Exchange for group purchasing or collective IT vendor.
New Mexico submitted a response to the U.S. Department of Health and Human Services’ request for comments regarding Health Insurance Exchanges.
High Risk Pool:
State-Run. The New Mexico Medical Insurance Pool (NMMIP) offers both the state high risk pool plan in existence since 1987 and the new federal high risk pool plan.
Additional Grants and Funding:
- The state applied for and was awarded a $1 million rate review grant
- The state received a consumer assistance program grant
- The state applied for a Money Follows the Person Rebalancing Demonstration planning grant
Other State Actions, Indicators, and Health Reform Resources:
- Health Care Reform Leadership Team’s potential legislation for 2011 session
- HCR Leadership Team presentation to Legislative Finance Committee on Implementation
- HCR Leadership Team presentation to Legislative Health and Human Services Committee
- Division of Insurance Bulletin to Insurers on ACA provisions effective on September 23, 2010