HOUSE HEALTH AND GOVERNMENT AFFAIRS COMMITTEE SUBSTITUTE FOR

HOUSE MEMORIAL 18

50th legislature - STATE OF NEW MEXICO - second session, 2012

A MEMORIAL

REQUESTING THE NEW MEXICO OFFICE OF HEALTH CARE REFORM AND THE HUMAN SERVICES DEPARTMENT TO IMPLEMENT AN INTEGRATED ENROLLMENT SYSTEM FOR MEDICAID, ANY HEALTH INSURANCE EXCHANGE AND BASIC HEALTH PROGRAM COVERAGE.

     WHEREAS, the federal Patient Protection and Affordable Care Act of 2010 was enacted on March 23, 2010 to launch comprehensive health care reform; and

     WHEREAS, the overall approach of the federal Patient Protection and Affordable Care Act to expand access to health care requires most United States citizens and legal residents to have health insurance; and

     WHEREAS, the act expands medicaid to all citizens and qualifying immigrants earning up to one hundred thirty-eight percent of the federal poverty level; and

     WHEREAS, the act requires states to create health insurance exchanges through which individuals and small businesses can purchase health insurance coverage; and

     WHEREAS, the act provides that states may opt, through a basic health program, to offer a selection of health plans at prices families can afford as a bridge between medicaid and the private insurance market; and

     WHEREAS, the New Mexico office of health care reform projects that by January 1, 2020, more than one million New Mexicans, or one-half of the state's population, will have access to health care through medicaid, a health insurance exchange or basic health program coverage; and

     WHEREAS, under federal health care reform, more than one hundred fifty thousand New Mexican adults will be newly eligible for medicaid; and

     WHEREAS, more than two hundred fifty thousand individual New Mexicans, as well as many small employers, are projected to be eligible for federal subsidies to purchase health care coverage through an exchange; and

     WHEREAS, under the Patient Protection and Affordable Care Act, states must develop a streamlined enrollment system by January 1, 2014 that provides a single application for determining eligibility for medicaid, as well as for any health insurance exchange and any basic health program coverage, and that ensures no wrong-door access; and

     WHEREAS, under the act, states must establish procedures for conducting outreach and enrollment for vulnerable and underserved populations and develop a community-based navigator program for the exchange that assists consumers with applying for all of the health care subsidy programs; and

     WHEREAS, under the act, the enrollment system and application process for insurance premium credits and cost-sharing subsidies should be easy to use and understand and be accessible to those with disabilities or with limited English-language proficiency; and

     WHEREAS, the human services department will receive federal matching funds that will pay ninety percent of the costs of developing a new computer system for medicaid that is capable of coordinating application and enrollment functions with other public benefits and health care programs; and

     WHEREAS, the New Mexico office of health care reform was awarded thirty-four million two hundred thousand dollars ($34,200,000) in federal grant money to establish an exchange, including funds to develop an enrollment system for the exchange that will provide online applications, telephone support and navigators and that is capable of coordinating enrollment functions with the medicaid program;

     NOW, THEREFORE, BE IT RESOLVED BY THE HOUSE OF REPRESENTATIVES OF THE STATE OF NEW MEXICO that the New Mexico office of health care reform and the human services department be requested to plan and develop a streamlined enrollment system for medicaid, any health insurance exchange and basic health program coverage; and

     BE IT FURTHER RESOLVED that the planning and development process include among its goals:

          A. implementation of an enrollment system that provides a single standardized application for the health subsidy programs;

          B. enrollment in person, by mail, online, by facsimile or by telephone;

          C. using an enrollment application form that is easy to use and understand;

          D. a reduction in paperwork for applicants;

          E. data exchanges between state and federal agencies wherever possible;

          F. collection of only information necessary for enrollment;

          G. access for people with disabilities;

          H. language interpretation and translation services;

          I. statewide outreach and a community-based navigator program that reaches underserved communities; and

          J. prompt determination of program eligibility to minimize gaps in coverage; and

     BE IT FURTHER RESOLVED that the New Mexico office of health care reform and the human services department cooperate in the collection and analysis of data to assess:

          A. enrollment and retention rates;

          B. reasons for denial of enrollment applications; and

          C. disparities in access to coverage and the utilization of services; and

     BE IT FURTHER RESOLVED that the planning and development process consider:

          A. whether to adopt the application developed by the United States secretary of health and human services under the federal Patient Protection and Affordable Care Act or develop a separate state form;

          B. data collection standards for information such as race, ethnicity, primary language, location, gender, age and disability status;

          C. methods to improve retention rates, such as renewing eligibility based on information from a public benefits program;

          D. the confidentiality of personal information collected and its protection from unauthorized disclosure; and

          E. acceptance of alternative documentation, such as self-attestation, as proof of eligibility; and

     BE IT FURTHER RESOLVED that stakeholders, including consumers, small employers, representatives of federally recognized Indian nations, tribes and pueblos located in New Mexico, off-reservation Native Americans and organizations that represent the disabled, women, children, the elderly and low-income families, be given the opportunity to provide meaningful input in the planning and development process; and

     BE IT FURTHER RESOLVED that the New Mexico office of health care reform and the human services department be requested to make periodic and final reports on the implementation of an integrated enrollment system for medicaid, any health insurance exchange and any basic health program coverage to the interim legislative health and human services committee; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the New Mexico office of health care reform and the human services department.

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