Affordable Health Care—Is It Possible?

Already through two cups of tea, and my friend was still telling me about her last visit to the doctor. The story took so long to tell, not because she is long-winded, but because there were so many different things that happened in her tale of a day-long doctor visit and subsequent day-long trip to a specialist. Still sipping my sweet Yogi tea, I became worried about insurance coverage for such complicated consultation, but she looked at me blankly, “Health insurance? I'm self-employed, I can't afford it.”

My friend doesn’t stand alone. A lot of people are in the same situation—almost one in four people in the state lacks health insurance, according to Health Action New Mexico, and one in five children. Most uninsured or under-insured adults are working but still can't afford insurance. So what's being done about this? Is affordable health care for all New Mexicans possible?

With some new legislation, it just might be.

Sen. Jeff Bingaman will soon be spearheading a bipartisan effort to pass the Health Partnership Act, which would provide federal support for state-based health care reform initiatives. States would have flexibility to design their own federally funded programs to reduce the number of uninsured. Congress would set the standards for adequate access and coverage, and provide financial incentives for states to expand coverage and improve health care.

Here in New Mexico, the discourse has moved quite a bit from the days when I, as a senate staffer, analyzed the only universal health care proposal around—a single-payer system called the Health Security Act. That was 10 years ago. Now, a broad coalition of organizations has formed the Health Care for All Campaign. They will ask the Legislature to pass a bill which would fund a study of several different models of providing access and financing for universal health care in New Mexico.

According to Health and Human Services (HHS) Interim Committee Chair Rep. Danice Picraux, who will be sponsoring the bill in the House, the main points of the bill will be what we as a state want in terms of health care and how much we’re willing to pay for it. The bill came out of the HHS Committee with bipartisan support and a request for $500,000. This would be a one-time expense that would be funded in the budget to be approved during the 2006 Legislative Session beginning on Jan. 17.

For years, the Legislature considered only the Health Security Act, which didn't pass, partly due to unknown costs. Rep. Picraux agrees we've come a long way, saying, “We used to think that we just needed to focus on health care for the poor, but now we're looking at working people who also can't afford to pay into a health plan. If the deductible and co-pay are too high, it doesn't matter what program you have if you can't afford your share.” Of course, a study would constitute only the first step in devising a health care system. Picraux sees the major challenge now as structuring the legislation so the study is fair and open, so “we get the depth of information that we need to give all New Mexicans access to affordable health care.” Seven other states have done this type of study, but Maine is the closest to actually funding a plan.

The models being considered for inclusion in the New Mexico study are our current system plus: a market-based insurance model, which is funded by taxes from employers and individuals; a provider of choice model similar to the Health Security Act; and a multi-payer model giving businesses the option to participate. Excluded from consideration will be a government-owned health system, like the ones in Canada and the U.K., and the “pay or play” model, which makes employers responsible for health insurance costs and may not cover everybody.

“This is a long-term process, and it won't happen overnight, but we're encouraged with this step forward,” says Charlotte Roybal of Health Action New Mexico, the campaign's fiscal sponsor and lead agent. “We have to reform the health care system, and finding out the cost is a good way to start that process.”

I hope the Legislature and the governor can support this bill so we can move the discussion along faster and find a solution that will work. I don't want to see senate staffers 10 years from now analyzing more proposals, while working New Mexicans are still not getting affordable health care. We should be ready to act if Sen. Bingaman's bill passes, and the New Mexico study will help us respond. Contact your legislators (visit legis.state.nm.us/lcs/ for contact information) and tell them how important it is to study the costs now so we may develop a plan for affordable health care for the future.