SENATE JOINT MEMORIAL 70
47th legislature - STATE OF NEW MEXICO - first session, 2005
INTRODUCED BY
Linda M. Lopez
A JOINT MEMORIAL
REQUESTING AN AUDIT OF STATE APPROPRIATIONS AND REVENUES RELATED TO HEALTH CARE.
WHEREAS, medicaid is the fundamental guarantee of health care coverage for the nation's most vulnerable citizens, including low-income women and children, people with disabilities and senior citizens; and
WHEREAS, in New Mexico, over twenty-two percent of the population is served under the medicaid program with an additional twenty percent of the state's population being completely uninsured; and
WHEREAS, enrollment in the medicaid program grew by eight percent in fiscal year 2004 and state officials expect a six percent increase in enrollment in fiscal year 2005 and a four percent increase in fiscal year 2006; and
WHEREAS, medicaid remains the workhorse of the health care industry and the most cost-effective way to subsidize health insurance coverage due to the favorable federal match of nearly three dollars ($3.00) for every one dollar ($1.00) of general fund money spent; and
WHEREAS, the state reduced medicaid spending by forty million dollars ($40,000,000) this year, and anticipates a need for an additional thirteen million dollars ($13,000,000) in reductions next year, which may require cutting benefits and possibly reducing eligibility; and
WHEREAS, the legislature and the state executive branch have worked tirelessly for several years to identify and implement cost-saving initiatives in the medicaid program, leaving little room for additional reductions without reducing access to health care for the most vulnerable citizens; and
WHEREAS, several hundred million dollars of New Mexico's general fund dollars are spent on programs and services often combined into various categories identified as "health care"; and
WHEREAS, while many auxiliary services are indispensable in providing direct health care, many are complementary but not critically necessary to those direct services; and
WHEREAS, unlike the federal medicare program that for decades has demonstrated bare-bones administrative expenses of three percent and sometimes one-half of that figure, administrative costs of New Mexico's managed care medicaid are far from clear and generally estimated to be at or above twelve percent annually; and
WHEREAS, the legislature needs to be substantially better informed on managed care direct-care costs reported from administrative costs; and
WHEREAS, no accounting has been done to determine the amount of health care spending by the state unrelated to the direct provision of health care services; and
WHEREAS, in order to make informed policy decisions about the potential for efficient redistribution of dollars, the legislature would benefit from knowing precisely how much health care spending does not support the provision of direct health care services;
NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that the New Mexico health policy commission in cooperation with the department of finance and administration be requested to convene a task force to audit fiscal year 2006 appropriations for health care to determine how that spending is allocated; and
BE IT FURTHER RESOLVED that the audit identify dollars that are not being used for direct patient care that could be used to provide an increased state share of funds for medicaid; and
BE IT FURTHER RESOLVED that the task force include representation from the department of health, the aging and long-term services department, the children, youth and families department, the human services department, the corrections department, the general services department, the commission on higher education, the vocational rehabilitation division of the public education department, the taxation and revenue department and others with knowledge and experience in health care, as appropriate; and
BE IT FURTHER RESOLVED that the audit identify which dollars can be attributable to direct patient care and which are used for ancillary purposes; and
BE IT FURTHER RESOLVED that the audit identify and justify the amount and distribution of administrative costs incurred by managed care organizations in the medicaid program; and
BE IT FURTHER RESOLVED that special sources of revenue utilized for health care appropriations be identified, including the tobacco settlement fund, revenue from other class action lawsuits, research grants, foundations, taxation earmarked or otherwise dedicated to support health care purposes such as cigarette and alcohol taxes and that the distribution of those revenues be identified; and
BE IT FURTHER RESOLVED that the cost of all commissions, task forces and committees relating to health care and disease be identified and included as an expenditure, including the expense of this task force; and
BE IT FURTHER RESOLVED that special funds with health-related purposes be identified and accounted for, including accounts of professional boards, undesignated funds in the risk management division of the general services department that are above actuarial estimates of solvency, health-related state investment council funds, the funds of the insurance division of the public regulation commission and any other funds that can be identified; and
BE IT FURTHER RESOLVED that funding used for the education of health professionals and distributed by the commission on higher education be identified and accounted for; and
BE IT FURTHER RESOLVED that the audit identify appropriations made to state entities that are expended outside of the state; and
BE IT FURTHER RESOLVED that the results of the audit be presented to the legislative health and human services committee and the legislative finance committee at their respective October 2006 meetings; and
BE IT FURTHER RESOLVED that copies of this memorial be sent to the director of the New Mexico health policy commission, the secretary of finance and administration, the secretary of health, the secretary of aging and long-term services, the secretary of children, youth and families, the secretary of human services, the secretary of corrections, the secretary of general services, the commission on higher education, the secretary of taxation and revenue and the secretary of public education.
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