By Ann E. Kepley, Precinct 132 Chair, DPSC
All New Mexicans deserve a home- grown health care system that reflects our unique healthcare needs.
New Mexicans deserve an affordable plan that provides coordinated preventive care and aftercare for patients while giving them the ability to choose caregivers and receive care close to home. These are the objectives of the Health Security Plan for New Mexicans.
The Big Picture
If implemented, the Health Security Plan shifts private insurance to a supplemental role, just as traditional Medicare does. As a result, Plan members will have guaranteed, comprehensive, quality health care coverage, including mental health care, regardless of income level or health and employment status. In addition, New Mexicans will have freedom of choice of healthcare provider and facility (no more networks), even across state lines.
The Health Security Plan will automatically cover most New Mexico residents.
- Federal retirees.
- Active duty and retired military.
- TRICARE recipients who will continue with their federal plans.
In addition, the pueblos and tribes, as sovereign nations, may choose to join the Plan. Health plans covered under ERISA also have the option of joining the Plan.
Developing the Details
In 2021, the state legislature set aside $575,000 to pay for the first year of the Health Security planning and design process. Under the auspices of the Office of the Superintendent of Insurance, this process focused on the operational details.
State Senators Jerry Ortiz y Pino and Liz Stefanics will shepherd The Plan in the 2022 short session. The proposed bill requests $1.5 million to continue research in the design process. The design process allows for the hiring of consultants to provide critical information needed for automatic comprehensive coverage for most New Mexicans.
On October 19, 2021, Superintendent of Insurance Russell Toal outlined the 2021 research areas. The four areas of research are:
Research Issue #1—Federal Laws and Waivers
Experts at George Washington University are completing research on federal laws and waivers applicable to the Health Security. Their analysis will explore what the federal regulations say and what waivers are available to help shape the Health Security Plan’s design.
Research Issue #2—Provider Payments
Experts from Columbia University and Rutgers University are researching provider payment options. They will analyze payment models and methodologies used in other countries and states and gather healthcare providers’ input. Their report will encompass such areas as policies and models for pricing health care services, utilizing U.S. and international models, integrating lessons from the U.S. and international experiences, and proposed benchmarks.
Research Issue #3—Global Budget
New Mexico and national experts are researching global hospital budgets. They will provide an overview of global budgeting, examples from other countries/states, opportunities and challenges, and information on other key topics. Their report will address feasibility and implementation barriers and provide recommendations. (Global budgets are a system under which hospitals receive predictable and sustainable revenue to cover their costs.)
Research Issue #4—The Future
An expert from New Mexico State University is preparing analysis on future needs for this health care program.
For more information on The Plan, go to https://www.nmhealthsecurity.org.
You may email
Senator Jerry Ortiz y Pino at email@example.com or
Senator Liz Stefanics at firstname.lastname@example.org
To contact your legislator, go to https://nmlegis.gov click on Legislators to get their contact information