Indigent care providers unsure of what to expect with health care changes [Carlsbad Current-Argus, N.M.]

Dec. 30--CARLSBAD -- As Congress draws closer to passing health care legislation that will require nearly all Americans to get health insurance coverage, administrators of indigent care funds in counties across New Mexico are unsure of the impact it will have on their programs.

"I know it is something we are going to address when we meet at the New Mexico Association of Counties mid-winter conference in Santa Fe on Jan. 18," said Linda Martinez, Eddy County indigent claims administrator. "We will be looking at how the health care overhaul is going to affect not only indigent programs, but also Medicare and Medicaid."

Under state statute, indigent programs in New Mexico's 32 counties are funded through a gross receipts tax. The exception is Bernalillo County, which has a mil levy that generates about $88 million and goes to the University of New Mexico Hospital for indigent health care.

In Eddy County, a one-eighth of 1 percent gross receipts tax is split between the county and the state. The county gets one-sixteenth of 1 percent and the states gets the other one-sixteenth of 1 percent. The revenue that comes to the county for indigent care is about $3.2 million annually, Martinez said.

"I don't think the state can take that money away from us," Martinez said. "The state statute is pretty specific in what indigent funds can be used for. Some counties have quite a bit of money in their indigent reserve fund.

"The

question that we need to have addressed is: What happens to the indigent program and the funds if Congress passes legislation requiring everyone to have health insurance coverage? That's a question we are going to have to ask our state legislators," Martinez said. "To use our indigent funds for something else other than what is specifically set in the statute would require the statute having to be changed."

Rep. John Heaton, D-Carlsbad, said state legislators are already working to address the issue.

"There probably will still be a need for those (indigent) funds," he said. "Both the (federal) House and Senate plan covers an additional 33 million (people). That leaves about 47 million that will still have no insurance."

Heaton said the proposed federal health care plan will "dramatically expand" Medicaid. He said New Mexico and other states will probably see an increase in Medicaid recipients.

Under the federal health plan, the eligibility level will basically be raised up to 150 percent of the federal poverty level, which will make it more acceptable to families to enter the Medicaid program, Heaton said, adding that with the potential for more people coming into the Medicaid program, New Mexico needs be on its toes to make sure it gets its fair share of federal matching dollars for the state's Medicaid program.

"The federal matching funds will begin at 100 percent and then decline to the normal matching rate. That's one plan that is being proposed. The other plan is a 90 percent federal match and 10 percent matching by the state," Heaton explained. "The challenges for our state will be using county money to get the federal match. So much of (indigent fund) county money doesn't get matched because it is administered at the local level."

He said that at the legislative level there as has been a lot of discussion in how to match the one-16th of 1 percent that comes to the state.

"There has been a lot of discussion on whether it should go automatically into sole community provider funding and not be left on the table, or somehow get it integrated into the state match," Heaton said.

He said there is about $24 million in indigent funds administered by the counties that in large part is not being matched. From the matching funds perspective, that $24 million could turn into $100 million federal.

"We have been looking at how better and more effectively to get that money matched. I know many counties are pushing back and not wanting the state to get the money. I think the state is going to have a bigger responsibility for matching funds," Heaton said.

Although state legislators are already addressing issues that may impact the state's health care system and indigent programs, Heaton said it is difficult because there are still many unknowns with the federal health care bill.

"It's hard to make decisions when you don't know what the bill is. Then we have to wait for the new rules to be written and all the regulations written that are associated with each component of the bill. But health care reform is needed. We have to get our arms around health care costs," he added.

To see more of the Carlsbad Current-Argus, or to subscribe to the newspaper, go to http://www.currentargus.com.

Copyright (c) 2009, Carlsbad Current-Argus, N.M.

Distributed by McClatchy-Tribune Information Services.

For reprints, email [email protected], call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.