Counties look to save indigent funds

By Gabriel Monte: CNJ staff writer

New Mexico counties are fighting to keep a program that funds indigent health care and keeps health care costs from rising.

A temporary suspension Congress imposed preventing a new Medicaid rule expires in May, according to Interim Curry County Manager Lance Pyle.

The rule terminates a state and federal partnership that pays medical bills for indigent residents treated at sole community health care providers, according to New Mexico Association of Counties Health Care Affiliate Chairwoman Rhonda Burrows.

“And one of the grimmest parts about it is we’re really not prepared for it,” she said.

During its Nov. 20 meeting, Curry County commissioners passed a resolution opposing the ruling and calling for Congress to extend the moratorium.

With about 24 percent of New Mexico residents uninsured, the sole community provider program makes health care accessible to people who qualify as indigents, she said.

“This is a safety net for those uninsured individuals,” Burrows said.

The state requires counties to come up with the funds to match the federal funds with a portion of gross receipt taxes. The federal funds match state funds 3-to-1 with money from Medicaid, she said. About 28 of the 33 New Mexico counties participate in the program.

She said about 10 New Mexico counties have passed a resolution opposing the ruling.

She said the Center for Medicaid Services is cutting the program to tighten its budget. She said the program is an easy target since it pays medical bills for non-Medicaid clients.

“But they created this dependency and now they want to (end it),” she said.

The Center ended the program in May but Congress passed a moratorium on the ruling in October, Burrows said.

“Unless we get some sort major legislative action, like another moratorium, then this rule is set to go in effect in May of 2008,” she said.
New Mexico Association of Hospitals President Jeff Dye said his association has committed about 171 members of the congressional delegation to extend the moratorium, but none from New Mexico as of yet.

She said the state and the National Association of Counties have been trying to recruit help from federal legislators to prevent the program’s termination. But she said she isn’t optimistic there would be enough support in the Senate to do it.

Without federal matching dollars, states will have to provide all the money for indigent health care, Burrows said. In the case of New Mexico, counties will have to foot the entire amount.

“I think the most direct effect is your hospitals will have to raise rates to those who are paying and services for those who are uninsured will be severely cut back,” she said. “And in some cases you may face hospital closures.”

Curry County has budgeted an average of about $300,000 for indigent health care every year, according to Pyle. Last year, it approved 637 medical bills from the Plains Regional Medical Center, which charged the county about $1.1 million.

Roosevelt county budgeted about $260,000 its indigent health care budget and paid for 128 medical claims from Roosevelt General Hospital, according to Portales Indigent Health Care Administrator Vicki Aguilar.

Pyle said the county also has a $350,000 contract with La Casa Buena Salud for primary health care for indigent residents..
Without government money, Pyle said the county will have to cut the services it will pay for.

“It’s a hard budget to do,” he said. “I will cut areas that have the least impact on the community.”

PRMC administrator Hoyt Skabelund said the hospital will not turn patients away but could gradually increase health care costs without the program.
“It would take a lot of services to replace that much lost revenue,” Skabelund said.

Fast facts

In Curry County, families with an annual income is less than $24,500 a year and single residents with an annual income less than $16,000 year are qualified for indigent health care.

The Curry County Indigent fund covers:
Dental Care
Primary Health Care Services
Hospital Charges
Out of County Hospitalization Charges
Inmate health care