Texas Tech University Health Sciences Center
The ACA and the Land of Enchantment

The ACA and the Land of Enchantment

the-aca-and-the-land-of-enchantment- image0Living in West Texas, we have a natural relationship with the state of New Mexico. Many of us are very fond of that state and visit it frequently. I know I do. It is a wonderful place. From a business and professional perspective, we treat many patients at Texas Tech Physicians from New Mexico. Last fiscal year, 6.03% of our patients came from New Mexico. We are, after all, the “Hub City.”

So, it's interesting to see what is going on in that state regarding the expansion of Medicaid. But, before we jump into that topic, it is necessary to present a little background and that is simply to say that many Americans with low incomes now have health coverage they wouldn't have had before under the Affordable Care Act (ACA). However, as I thought at the time the law was passed, while seeing more people with health care coverage is a good thing, where will people with Medicaid receive care? Where are they receiving care? I participated in a meeting in Austin last week where it was reiterated that only about a third of the physicians in Texas accept Medicaid.

Now, back to New Mexico, a state, by the way, which has the highest proportion of Medicaid recipients in the nation. The ACA added 150,000 New Mexicans to the Medicaid rolls almost overnight. This brings their total enrollment to 731,000 people, or about one in three residents. According to an article in the Wall Street Journal, these people are having difficulty obtaining a provider to see them.

Historically, Medicaid covered only the poorest disabled people, pregnant women and mothers and children in most states.  The new law expands eligibility to anyone earning up to a third more than the poverty level or around $15,000 a year for a single person. Medicaid is seeing an influx of male enrollees and others who are not heretofore eligible for coverage. New Mexico is trying to increase its physician population while looking to fill the gap with healthcare providers such as nurse practitioners.
I think this is interesting to observe since we interact with the good citizens of New Mexico to the degree that we do.

Another thing worth watching is that the ACA reduces what the federal government wishes to pay to defray uncompensated care cost based on the assumption that more people with health care coverage would mean fewer unpaid bills. We welcome our patients from New Mexico. We are glad they select us for medical services, and we do our best to work with the four state-sanctioned Medicaid insurance companies operating in New Mexico to obtain a fair payment for services provided to the citizens of the Land of Enchantment.