Against the backdrop of rising costs for health coverage, uncertainty regarding stability of the individual market and the state’s persistently high uninsurance rate of more than 9%, New Mexico is considering a Medicaid buy-in strategy. Medicaid is New Mexico’s largest payer, covering more than 40% of the state population, and can serve as a key lever to help the state increase coverage affordability and improve access to care. Specifically, the state is exploring a state-sponsored coverage option that leverages the Medicaid program —via its “purchasing power” as the state’s largest payer and its well-established Medicaid managed care plans, Medicaid provider network, and provider reimbursement rates—to offer a more accessible and affordable statewide coverage option.
Together with Health Action New Mexico, New Mexico Center on Law and Poverty, Partnership for Community Action, and Strong Families New Mexico, Manatt Health produced a report to inform state decision makers with regard to pursuing a Medicaid buy-in. The report was commissioned by the New Mexico state legislature and provides a qualitative assessment of several Medicaid buy-in options for New Mexico, incorporating feedback from a diverse group of New Mexico stakeholders.
Keeping the goals and objectives of the stakeholders in mind, Manatt crafted four potential buy-in options for New Mexico. The proposals vary in their complexity, the required federal authority and the risks, as well as in their “reach” in covering uninsured New Mexicans. Notably, these options are not mutually exclusive and could be implemented separately, sequentially or in combination with one another. Based on Manatt’s assessment, all of these models would help New Mexico make headway in its quest to expand coverage, improve affordability and increase access to care. The report is the first in a two-phased study on Medicaid buy-in for New Mexico. In the next phase, Manatt will work with actuarial consultants to model a potential buy-in program for New Mexico.
Click here to read the report.