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Nov/Dec 2007

New Mexico Unveils New Health Care Reform Proposal

At the end of October, Governor Bill Richardson (D) unveiled a comprehensive reform blueprint to provide all New Mexicans with health insurance coverage and to redesign the way health care is delivered in the state. Under Richardson’s HealthSOLUTIONS New Mexico proposal, state residents would be required to purchase coverage. Those residents who meet income qualifications would be eligible for lower cost state-subsidized plans. The plan would require employers to contribute to a “Healthy New Mexico Workforce Fund” to help fund the proposal, with employers receiving a dollar-for-dollar offset if already contributing towards their employees’ health coverage. Other aspects of the proposal include:

  • Insurance Reforms: an 85 percent Medical Loss Ratio for insurance carriers, guaranteed issue with no exclusion of pre-existing conditions, limit the rating bands in the small group market, increase transparency and accountability through common data reporting requirements, a moratorium placed on new insurance benefit mandates through 2010, allowing Indian Health Services and tribal providers to be part of a carrier’s provider network;
  • Electronic Health Transactions and Information: requiring electronic claims submission, developing a plan requiring the use and exchange of electronic medical records, and protecting patient privacy and right to information;
  • Health Coverage Authority: Creating a single point of accountability for data, analysis, plan management, and policy to increase coverage and access, and control costs; and
  • Evaluation: Implementing an evaluation component to assure policy and structures are accountable in meeting defined goals.

As part of his proposal, Richardson signed an executive order that will require contractors doing business with the State to demonstrate that they offer health coverage when working in New Mexico. The order will go into effect in July 2008 and be phased in over three years.

Undocumented immigrants and some legal immigrants who have been in the U.S. for less than five years would not be eligible for coverage under the Medicaid components of the plan due to federal restrictions. Richardson, who is a presidential candidate, will ask the state legislature to consider his proposal in 2008.