SENATE JOINT MEMORIAL 50
49th legislature - STATE OF NEW MEXICO - second session, 2010
INTRODUCED BY
John Pinto
A JOINT MEMORIAL
REQUESTING THAT MEDICAID FUNDING MEET ENROLLMENT NEEDS AND THAT CUTS TO ELIGIBILITY AND SERVICES BE AVOIDED; REQUESTING THE DEVELOPMENT OF A PROGRAM TO ESTABLISH NATIVE AMERICANS IN A SEPARATE CATEGORY OF MEDICAID ELIGIBILITY WITH ITS OWN BENEFITS PACKAGE.
WHEREAS, on September 24, 2009, the medical assistance division of the human services department announced a series of cuts expected in medicaid budgets affecting tribes in New Mexico; and
WHEREAS, the human services department is bound by the state-tribal consultation policy announced by the governor and is required by the federal stimulus act, the American Recovery and Reinvestment Act of 2009, to consult with federally recognized tribes on any medicaid plan amendments, waiver requests and proposals that are likely to have a direct impact on Indian health programs and Native American medicaid beneficiaries; and
WHEREAS, the human services department issued a state-tribal consultation, collaboration and communication policy that outlines the history of the State-Tribal Collaboration Act signed into law on March 19, 2009; and
WHEREAS, the human services department's consultation policy includes the review of programmatic actions and the determination of whether such actions may have tribal implications; and
WHEREAS, the Indian health service and tribal programs under Public Law 93-638 are the primary health care providers for Native Americans in New Mexico, and, currently, seventeen percent of the Indian health service's base budget is derived from third-party revenue, which includes medicaid; and
WHEREAS, the federal government's spending for health care in tribal areas is less than one-half of that spent for the country's prisoners; and
WHEREAS, medicaid is important to the state's economic recovery, and, with the temporary enhanced federal match, is currently bringing in nearly four dollars ($4.00) of federal match money for every one dollar ($1.00) spent on the program and, in fiscal year 2007, medicaid generated three billion three hundred sixty million dollars ($3,360,000,000) in economic activity in New Mexico; and
WHEREAS, medicaid spending sustains more than forty thousand jobs in New Mexico, and, according to the university of New Mexico's bureau of business and economic research, for every one hundred million dollars ($100,000,000) cut in state funds, five thousand jobs are lost; and
WHEREAS, the human services department issued a medicaid concept paper that outlines a proposed medicaid redesign of services; and
WHEREAS, the impact of the medicaid redesign on tribal communities, programs and individual members has not been provided by the human services department, although it is required that tribal leaders and their appointees and the Indian health service be given information about the impact of the redesign so as to provide important systemic input into the redesign of medicaid services; and
WHEREAS, medicaid offers vital health care services and access for eighty-three thousand four hundred two Native Americans of whom fifty-five thousand two hundred fifty-two are children and the others include people with disabilities, the elderly and low-income families on and off the reservations; and
WHEREAS, based on data from the United States census bureau, an estimated forty-three percent of the New Mexico Native American population is currently enrolled in medicaid, and an estimated thirty-two percent of New Mexico Native Americans are uninsured; and
WHEREAS, in 2009, the state medicaid budget was three billion four hundred million dollars ($3,400,000,000), and in 2004, New Mexico spent two hundred seventy-two million dollars ($272,000,000), less than eight percent of the total medicaid budget, for Native American medicaid recipients; and
WHEREAS, compared with all other groups in New Mexico, Native Americans experience an overall lower health status and rank at or near the bottom of other social, educational and economic indicators, which indicators include a life expectancy that is four years less than the overall United States population and higher mortality rates involving diabetes, alcoholism, cervical cancer, suicide, heart disease and tuberculosis, and higher rates of behavioral health issues, including substance abuse; and
WHEREAS, the human services department has committed resources to address these disparities, recognizing that a community-based and culturally appropriate approach to health and human services is essential to maintain and preserve Native American cultures; and
WHEREAS, the medicaid program lost significant funding, over two hundred million dollars ($200,000,000), in 2009, when state funds were taken from medicaid to address other parts of the budget, and the program was temporarily sustained by federal stimulus funds that will expire at the end of 2010, and possibly 2011, if extended, which will have an effect on enrollment procedures, provider rates and services for Native American recipients, even at the one-hundred-percent federal medical assistance percentages allocation; and
WHEREAS, medicaid is vital for on-reservation Indian health services and tribal programs under Public Law 93-638 and sustains health care jobs in the Indian health service system; and
WHEREAS, in 2000, the per capita income on the Navajo Nation, seven thousand two hundred sixty-nine dollars ($7,269) per year, was one-third of the per capita income for the rest of the United States, and, overall, per capita income for Native Americans averages twelve thousand eight hundred ninety-three dollars ($12,893) per year; and
WHEREAS, the unemployment rate on the Navajo Nation has doubled from twenty-five and six-tenths percent in 2000 to fifty and one-half percent in 2007; and
WHEREAS, Navajo Nation President Joe Shirley has written a formal request to the medical assistance division requesting consideration of the Navajo Nation's opposition to tribal health cuts; and
WHEREAS, any cut whatsoever to medicaid expenditures for the chapters of the Navajo Nation, the pueblos, the Jicarilla Apache Nation and the Mescalero Apache Tribe will have a significant and disparate impact on a very vulnerable system of health care delivery;
NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that the legislature recommend that medicaid be fully funded to meet enrollment needs and to avoid cuts to eligibility and services and that state funds be restored to establish the baseline of funding for the program and that these funds not be reduced again if the federal stimulus is extended into state fiscal year 2011; and
BE IT FURTHER RESOLVED that no major changes be made to tribal health services delivery or funding, absent a formal tribal consultation, so as to establish a process to develop a Native American coverage program utilizing the state consultation process for inclusion of tribal representatives, the Indian health service and tribal leaders in developing a Native American coverage plan acceptable to New Mexico's twenty-two tribes, nations and pueblos; and
BE IT FURTHER RESOLVED that a program be developed to establish Native Americans as a separate category of eligibility with its own benefits package; and
BE IT FURTHER RESOLVED that the medicaid program be protected from structural changes that would reduce coverage and services and that an approach toward medicaid that is aligned with the purposes of national health care reform be developed to ensure health care coverage for low-income people; and
BE IT FURTHER RESOLVED that revenues for medicaid be raised using options that create a fairer tax system and that alleviate the burden on working families and low-income New Mexicans; and
BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the governor, the secretary of human services, the medical assistance division of the human services department, the tribal leadership for all Indian tribes, nations and pueblos and the Indian affairs department.
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