January 2008

Presbyterian strongly supports universal coverage for New Mexicans. Today, one in four New Mexicans has no insured access to healthcare. When all New Mexicans have health coverage it will improve the health of our state, and will stabilize costs (end cost-shifting) for those who pay for insurance today. Presbyterian has constructively participated in healthcare reform and advocated for universal coverage for the last several years. The following principles guide our support for healthcare reform:

1. Access to basic healthcare services is a right and universal coverage is the best way to assure New Mexicans realize this right.
2. A universal coverage system should be a partnership between the public and private sectors.
3. A coverage mandate for all New Mexicans should be focused on prevention and evidence-based, medically necessary services.
4. Currently insured New Mexicans should keep their coverage, those that are not insured and can pay, should pay. Those that cannot pay should receive public subsidy.
5. A universal coverage model should focus on transparency of cost and quality to create improvements.
6. Any proposed system change must be financially and politically viable in the short and long run.
7. Every stakeholder must be willing to contribute to system change in order to produce universal health coverage in New Mexico.

Health Solutions New Mexico

Health Solutions New Mexico is Governor Richardson's proposal to expand health insurance for uninsured New Mexicans, reform health insurance practices, create new government oversight of healthcare, and plan for future healthcare policy and investments. Presbyterian values that Health Solutions New Mexico relies on the same public-private partnership that has created the successful Salud! model. We appreciate the open process and many stakeholders who have contributed to Health Solutions New Mexico. We support this proposal as it is drafted today; however, it is essential that the delicate balance of reforms holds together to create a better healthcare system for New Mexico. Any change to the proposal will have to be evaluated as to its impact on the overall plan.

The following are the main components of the Health Solutions New Mexico plan:

1. Insurance Reform. Require health plans to spend 87% of each healthcare premium dollar on direct medical services. Require health plans to guarantee coverage to individuals, without exclusions for pre-existing conditions beginning in 2009. Reduce health plans' ability to rate small groups based on medical experience. Impose moratorium on new health insurance benefit mandates through 2010. Entice insurance brokers to sell public products.
2. Coverage Mechanisms. Require individuals to show proof of coverage beginning in 2010. Require employers, who do not provide health coverage to employees, to pay up to $500/per employee/per year to a new fund, to be appropriated by the Legislature. Require all employers to provide a pre-tax health coverage option for employees, whether employers contribute financially or not. Expand individual buy-in to NMMIP, Medicaid and other pools.
3. Health Coverage Authority. Consolidate public insurance program administration. Define standard coverage, affordability guidelines, performance standards and complaint resolution. "Engage in activities" to address costs, enhance pay-for-performance, promote wellness, etc. Make policy recommendations to Governor and Legislature.
4. Electronic Health Transactions. Require electronic claims submission and payment by 2009. Create action plan for electronic medical record by 2010.

Thank you for your interest in Presbyterian's public policy efforts. If you have additional questions or feedback, please contact Todd Sandman, director of public and government relations, at tsandman@phs.org or 923-6578.

Read Jim Hintons' article from March 3, 2007, "A Moore's Law for Healthcare"