New Mexico State Senator Dede Feldman's Blog

Senator Feldman Meets with US Senators, White House to Help Shape Final Senate Health Care Bill

 

On Tuesday I was in DC, along with a delegation representing over 1,000 state legislators who have signed a statement of principles calling for comprehensive health reform including a public option. It’s the second time I’ve been to the Capitol as part of the White House Working Group of State Legislators for Health Reform. And what a historic week to be there!  As I write this blog, the Democrats have now assembled the 60 votes needed to overcome the bitter partisan divide that cast a pall over the Senate office buildings we visited.  But last week, that was far from certain, as the public option bit the dust and various alternatives were unsuccessfully floated. Among these was a Medicare-“buy-in” for people 55-65 yrs. old, which seemed to have some currency until Sen. Joe Lieberman (whose office is right next to Sen. Bingaman’s), dropped his bomb. Another alternative, a private non-profit plan operated by the Office of Personnel Management, which runs the Congressional plan, is still in the bill.

As Senate staffers continued to draft a bill, four of us delegated by the larger group (Rep. Sharon Treat, of Maine, Sen. Karen Keiser, of Washington, Rep. Krysten Sinema, of Az., and me) visited with the staff of the Senate HELP committee, Sen. Olympia Snow, Sen. Susan Collins, Speaker Nancy Pelosi, and Senator Maria Cantwell. I also met personally with Sen. Bingaman and Sen. Udall, and all of us met with Mike Hatch, White House Policy Advisor, at the White House.

Our message was clear.  “We need action now, and it must be affordable and comprehensive. “  To give details on how we felt the bill could be improved, we delivered a White Paper outlining key elements critical for effective reform, including “bridge” funding for the states to help pay for Medicaid and state health insurance programs, and comprehensive insurance reforms that would kick in immediately and, given the mandate to buy insurance, regulate insurance companies like public utilities.

With states playing a crucial role in implementation of the reforms, Senators and staffers welcomed our suggestions and stories.  Senator Bingaman was especially responsive to New Mexico’s Medicaid eligibility dilemma, which threatens to scuttle our State Coverage Insurance (SCI) program.  Today his office notified me that he was able to get an amendment into final version, which will be voted on this week.  It will allow our entire childless adult population that would be shifting into the new 1115 to receive maximum federal match. He also indicated that he felt confident that bridge funding to cover some Medicaid recipients who would no longer be eligible come 2014 would be forthcoming in other legislation.

As for stronger insurance reforms, amendments to the bill announced today also impose penalties on insurance companies for raising premiums when people get sick, and ban discrimination vs. pre-existing conditions in children immediately—not in 2014.

(For a link to the entire “Mangers Amendment” to the Senate Health Care Reform bill go to http://www.politico.com/static/PPM145_chris.html  )

Although I remain very disappointed that the public option is not in this bill, I still support it. I agree with both Bingaman and Udall, who told me that, with the second highest number of uninsured, and the nation’s fastest growing premiums, New Mexico stands to gain tremendously.  Exactly how much?    Over 360,000 New Mexicans who don’t have it now could get insurance, either with the help of subsidies or Medicaid.  That’s a major advance. 
(edited 12/21/09)

 

As Health Care Debate Enters Crucial Stage, Sen. Feldman Heads to Washington

    I’ll be heading to Washington early next week, along with legislators from other states, who have been designated to lobby the Senate on behalf of the White House Working Group of State Legislators for Health Care Reform.  The other legislators include Sen. Karen Keiser, of Washington, Rep. Sharon Treat, of Maine and Rep, Krysten Sinema, of Arizona.

            The visit comes as Democratic Senators, unable to muster 60 votes for a pubic option, are considering alternatives, including a private national plan administered by the Office of Personnel Management (OPM), which administers the Congressional health plan, and a buy-in to the Medicare program for people aged 55-64.

Our group had earlier gathered signatures of 1,000 state legislators to support a robust public option, and during the summer and fall have been holding town halls and other events to support reform. 

Many of us are chairs of health committees and involved in Medicaid or our own “public option” programs like the state coverage insurance (SCI) program here.  We’re focused on how these reforms are going to be implemented – since it’s the states that will be catching the ball from Washington. 

We’ll be meeting with the White House staff and visiting with Senators and their staffs, including that of Senator Bingaman and Sen. Udall.

I’m going to be stressing the urgency of “bridge” funding to carry our Medicaid and SCI programs forward until the full reforms kick in.  Due to our current budget crisis, we’re on the verge of ending SCI, and “restructuring” Medicaid, which means cuts in benefits, more co-pays, fewer programs, and lower reimbursements for providers.  Other states are doing the same thing.

As far as alternatives to the public option go, I hope they can save as much money-- $25 billion, according to the CBO— as the public option as well as increase competition and keep insurance companies premiums down.  Most important, these policies must be affordable, which means that middle-income people must have adequate subsidies to purchase them. 

The questions we’re going to be asking are whether these alternatives will really be national in scope, simple, portable and not just a costly, high-risk pool for those who can’t get coverage elsewhere. 

 Medicaid Matters

 I just attended the public hearing on Medicaid “restructuring’ Friday morning I’d say there were 200 people there, many of them disabled, or parents of disabled people. Each had a story on how cuts to therapies, increased co-pays, and reduced spending on behavioral health or other programs would not just decrease their quality of life—but threaten their very lives.  It was very sad. But it doesn’t change the fact that the Human Services Department is short $325 million due to huge increases in Medicaid enrollment, decreases in the matching rate from the feds, and the fact that the stimulus money keeping them afloat will end next year.

While waiting for the federal reforms to kick in (if they pass), the department is looking to restructure the program by scaling back benefits to the those now offered through the State Coverage Insurance Program (SCI).  This will mean a loss of vision, dental benefits (except as riders) and co-pays and premiums for the same services now covered fully.  At the same time the department proposes to allow employers to “buy in” to Medicaid and create new programs for children and adults not currently covered.   The restructuring does not apply to community based waiver programs like the DD, Medically Fragile, the HIV/Aids, and Mi Via waivers.

Here are some comments from the crowd.

“George Orwell is alive and well when cuts are called expansions.”

“This is an embarrassment.  We are not being responsible when we are even considering a 50% cut in these benefits.”

“When I hear about the 40% tax breaks given to the wealthy a few years back and then think about these little children now, it breaks my heart.”

To comment on the proposal or get information go to [email protected] or write Medicaid Coverage Concept, HSD Medical Assistance Division, PO Box 2348, Santa Fe, NM 87504-2348.