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Kim Willis

N.M. Legislative leaders lukewarm on health care opt-out


By: Health Insurance
Submitted: 2009-11-06 10:25:29 | Word Count: 789


U.S. Sen. Majority Leader Harry Reid said Monday health care reform legislation scheduled for the U.S. Senate floor in coming weeks would contain a public health care option with an opt-out clause for states.

How states opt in or out — whether by the Legislature or the governor, or some kind of combination of the two – remains unclear.

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But what seemed clear Tuesday is that a public health care option wouldn’t be a slam dunk in New Mexico if the decision fell to state lawmakers.

“I’m not a fan of public option. If you look at our public programs, they tend to cover fewer people for more money,” House Minority Leader Keith Gardner, R-Roswell, said Tuesday. “The cost is huge. Efficiency is poor.”

Of all the legislative leaders who spoke with the Independent, Gardner gave the most forceful response. Most legislative leaders adopted a wait-and-see attitude Tuesday, citing a combination of factors, from a lack of firm details to the complex, often arduous journey Congressional proposals travel to become law, during which a bill may take several forms.

“In concept, most people are in favor of it. But it’s all in the details. And that’s why I’d like to see (the legislation),” Sen. Majority Leader Michael Sanchez, D-Belen, said, echoing sentiments expressed by Sen. Minority Leader Stuart Ingle, R-Portales.

Both Sanchez and Ingle said they wanted to see what strings would be attached if a state opted in to a public health care option. Federal law sometimes requires states to take action without giving the state money to pay for it – what policy makers call an ‘unfunded mandate.’

“They make the states pay for their mistakes,” Ingle said. “Once you’re in it, you’re in it and they can change anything they want to. Governments are never known for their great efficiency, but the federal government is known for its great inefficiency.”

“My first impression is that we would not get into it,” Ingle added.

Sen. President Pro Tem Tim Jennings, D-Roswell, said he generally “found that the best health care is in the private markets. It scares me some to look at some of the things we have going on with Medicaid and Medicare. I think those things are ripe with fraud.”

Medicaid is the joint federal/state low-income health insurance plan. Medicare is the federal health plan for older Americans.

House Majority Leader Ken Martinez, D-Grants, meanwhile, said he opposed giving states the authority to opt in or out because he preferred allowing individuals, not states, to have the flexibility to voluntarily opt into a public health care option.

House Speaker Ben Lujan could not be reached for comment. A spokesman for Gov. Bill Richardson did not respond to an e-mail asking about the issue from the Independent.

Reid announced his intention to include a public health option in legislation after months of vigorous, sometimes very heated debate, about health care reform and what it should look like. U.S. senators are waiting to learn the details of Reid’s proposal just like everyone else, Jude McCartin, spokesperson for Sen. Jeff Bingaman, said Tuesday.

New Mexico has one of the highest uninsured rates in the country, with roughly 20 percent of its population going without health coverage.

That fact could factor into New Mexico’s decision to opt in or out if such health care reform becomes law, officials said. New Mexico is already very reliant on the federal dollars to help pay for health care. New Mexico receives nearly four dollars for every one it spends on Medicaid, when federal stimulus dollars are added in.

Sen. Dede Feldman, D-Albuquerque, long a supporter of a public health care option, said Tuesday it was too early to tell if Reid’s proposal might work for New Mexico.

“A lot of the details are not in yet,” Feldman said. “They are waiting for the price estimate for the public option. How do you opt out? Is it just a governor? Is it the governor’ and the legislature? We need to know those details. We need to know about Medicaid. The public health care option may be more or less needed depending on what happens to Medicaid.”

Feldman then listed several scenarios that, to her mind, could help her make up her mind.

“It’s a gigantic jigsaw puzzle,” she said.

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