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The Uninsured in New Mexico: What We Know and Don’t Know

The Uninsured in New Mexico: What We Know and Don’t Know. Insure New Mexico! Council September 29, 2004. How many?. According to the Current Population Survey, more than one in five New Mexicans (22.1%), lacked any type of health insurance coverage in 2003

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The Uninsured in New Mexico: What We Know and Don’t Know

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  1. The Uninsured in New Mexico:What We Know and Don’t Know Insure New Mexico! Council September 29, 2004

  2. How many? • According to the Current Population Survey, more than one in five New Mexicans (22.1%), lacked any type of health insurance coverage in 2003 • That percentage is up from 21.1% for 2002 and 20.7% for 2001 • New Mexico’s percentage is substantially above the national average of 15.2% and ranks us second in the nation for the rate of uninsurance; first for children without insurance

  3. How many? • The U.S. Census Bureau estimates that the state’s total population exceeded 1.87 million in 2003 • Therefore, New Mexico’s uninsured population now at 414,000 (about as many as on Medicaid – 420,000)

  4. Who are the uninsured? • Without any type of insurance for the entire year • Not a homogenous group • Nearly all under age 65

  5. What do we know? • 73% of the uninsured are age 19-64 • higher rate of uninsurance among 19-64 age group than among kids (largely due to number of children on Medicaid) • among the 19-64 age group, 60% of those uninsured are below 200% FPL • 35% of the uninsured are under 100% of the federal poverty level (FPL) • 18% of the uninsured are at or above 300% of FPL

  6. What do we know? • 38% of the uninsured adults report having a usual source of care that is not an emergency room and report no unmet needs for preventative care, specialty care, dental care, prescription drugs, emergency room care, hospitalization, medical tests, or medical procedures • 29% of the insured adults report having unmet health care needs Sources: U.S. Census Bureau, Current Population Survey; Health Policy Commission, Household Survey; & New Mexico Voices for Children

  7. What do we know?

  8. What we don’t know • What is the demographic breakdown of the uninsured within FPLs (age, gender, race/ethnicity, etc.)? • What is their relative attachment to the labor force? • How many could afford (by their own definition) some type of health insurance but don’t take it up and why don’t they purchase it? • How many uninsured individuals (by FPL) do not take up their employer-sponsored health insurance and why don’t they sign up? • How many are eligible for Medicaid but are not enrolled and why don’t they apply?

  9. What we don’t know • How many receive health care from a number of service providers, such as IHS, the Veterans Administration, primary care community clinics and university clinics (i.e., what is the level of overlap among these providers and their service populations)? • How many veterans, accessing care through the Veterans Administration, are satisfied with their health care? • How many Native Americans, accessing care through the Indian Health Service, are satisfied with their health care?

  10. What we don’t know Any unmet health care needs? Male or female? Employer insurance available? How many 19-40? Why not on S-CHIP? Attachment to labor force?

  11. Efforts to address coverage to date • Healthcare Coverage and Access Task Force – 2003 (several pieces of legislation): • Behavioral health purchasing collaborative • Comprehensive statewide health planning • Consolidation of public purchasing for state employees, local government employees, teachers, and retirees (to build on IBAC) • Past State Initiatives: • SCHIP Section 1115 waiver (expanded coverage to 235%) • HIFA 1115 Waiver (SCI) • High Risk Pool – NMMIP • Tax Credits to Individuals • Purchasing Alliance - NMHIA

  12. Challenges • Multiple fragmented efforts; inability to focus • Desire to address all uninsured at once (“all or nothing” mentality or address the lowest income individuals first) – incremental steps are needed • Polarized beliefs about role of private sector (ESI to Single Payer) • Any pooling is seen as single payer • Any effort is seen as not enough or addressing the wrong group first

  13. What next? • Governor Richardson still believes in private market with strong governmental role, not a single payer system • Governor Richardson believes in focusing where we can • Small employers (including non-profits) • Helping economy as well as uninsured • Governor Richardson believes in governments being good purchasers for their employees (e.g., Save Smart) • It will take a national effort to address the total issue

  14. Governor Richardson’s next steps • Focused effort on helping uninsured workers and small employers share in the cost of purchasing of health insurance, addressing three issues: • Cost of insurance • Lack of information • “Hassle” factor • Support for aggressive movement on SCI to cover 40,000 working low-income New Mexicans • Use of existing infrastructures - such as HIA

  15. Governor Richardson’s commitments • Continued efforts to hold down growth in Medicaid while keeping people covered/eligible • Continued efforts to consolidate public purchasers administratively and make the most of limited tax dollars

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