|
|
"Richardson
Promises Universal Health Care, But N.M. Still Waits"
By
Deborah Baker
Associated Press
July 18, 2007
SANTA
FE
— Bill Richardson tells Democratic voters that as president, he would
deliver
health coverage to all Americans. But after 4½ years as governor, the
universal
coverage that was his goal is still just a dream in New Mexico.
About one in four state
residents
under age 65 is uninsured, according to a recent report. Among New
Mexicans of
all ages, about one in five lacks insurance — putting the state just
behind
neighboring Texas,
which is ranked worst in the nation.
When he first ran for
governor in
2002, Richardson
said his objective was to cover every New Mexican in four years.
Critics say
the administration's piecemeal approach has barely made a dent in a
deepening
crisis.
"They have taken a number
of
baby steps but they haven't tackled the problem," said Ellen Pinnes, a Santa Fe health
care
consultant.
Campaign spokesman Pahl
Shipley
said Richardson
has laid the groundwork over the past four years for universal coverage
and
will propose a plan to the 2008 Legislature. It would make coverage
mandatory,
according to the administration.
"We're a poor state and it
isn't easy, but we're making progress. ... Our state has fewer
resources and so
it has been challenging," Shipley said.
With some 47 million
Americans
uninsured, health care is a top domestic issue for Democratic
candidates.
Barack Obama and John
Edwards
would increase taxes on the wealthy to pay for expanded coverage.
Obama's plan
— estimated to cost up to $65 billion annually — focuses on making
coverage
affordable to all. Edwards' proposal, with a price tag of up to $120
billion,
would require every American to be insured.
Hillary Clinton, who
spearheaded
the unsuccessful health care reform effort in her husband's
administration more
than a decade ago, hasn't released a detailed plan.
Richardson
proposes a $100 billion program to provide universal coverage without
raising
taxes, in part by diverting money now being spent in Iraq.
Among its features:
lowering the
age for Medicare coverage to 55, expanding Medicaid and State
Children's Health
Insurance Programs, and providing tax breaks to help others pay for
whatever
insurance they chose — even the plan that now covers members of
Congress.
He also promises more
investment
in preventive care and less spending on bureaucracy. He would clamp
down on
interest rates and protect credit ratings when consumers put medical
debt on
credit cards.
As the only governor in
the race, Richardson
has a record
on health issues that voters can scrutinize.
They may question whether,
given
his history at home, he can deal with the problem at the national
level, says
Matthew Streb, a political scientist at Northern Illinois
University.
"If he has this grand
national plan, why hasn't he been able to alleviate the problem of
uninsured
residents of New Mexico?"
Streb said.
Expanding Medicaid has
been a
linchpin of Richardson's
efforts to get more New Mexicans covered. But Medicaid enrollment was
only 3
percent higher in March than it was when the governor took office more
than
four years earlier.
Critics say tens of
thousands of
New Mexicans actually have been knocked off the Medicaid rolls, and
they blame
the governor's policies.
For a couple of years, the
administration — as a cost-containment move — required twice-a-year,
rather
than annual, re-certification of Medicaid recipients.
And if paperwork wasn't
processed
on time — sometimes because overloaded caseworkers couldn't get to it,
critics
allege — computers automatically terminated cases.
Critics say the two
policies
combined to erode Medicaid enrollment.
While re-certification has
been
returned to an annual timetable, the so-called autoclosure policy
remains in
place. Critics say even though most closed cases are reinstated,
children's
health care is disrupted in the meantime.
Richardson
stresses New Mexico's
efforts to insure children. Medicaid covers children up to 235 percent
— and
sometimes more — of the federal poverty level. Another program pays
half of
premiums for children who aren't Medicaid-eligible. And there are
programs
aimed at covering every pregnant woman.
But while Richardson
repeatedly has cited the state's
push to insure children under 5, nearly 16 percent of New Mexicans 5
and under
— more than 23,000 children — were uninsured in 2005, according to
recent U.S.
Census Bureau estimates.
Overall, an estimated
432,000 New
Mexicans were uninsured most of last year, according to a study done
for a
gubernatorial task force.
At Richardson's request — he called it
"a
huge step forward toward universal coverage" — lawmakers this year
expanded Medicaid to some previously ineligible adults. The program,
which begins
in August, is expected to add some 18,000 people to the Medicaid rolls
by the
end of the budget year, according to the Human Services Department.
Dr. Stan Handmaker, who
represents
the New Mexico Pediatric Society in the state's Medicaid Coalition,
says it's
"a step in the right direction ... a very small step, looking at the
size
of the problem."
Richardson has relied on a
bevy of
specialized programs to try to plug the gaps in health coverage: A
public-private program in which employers, workers and the state and
federal
government share the cost; a program for non-profits and other small
employers;
a pool for high-risk people rejected by commercial carriers; an
alliance for
small employers and the self-employed.
Copyright ©2007 Associated Press. All rights reserved. This material
may not be
published, broadcast, rewritten, or redistributed.
|