PDACNM NEWSLETTER June 4, 2018

DEMS NEED TO TALK ISSUES LIKE HEALTHCARE FOR ALL NOW
in response to attacks on Rep. Lujan Grisham

While PDACNM has had reason to be disappointed In Rep. Michelle Lujan Grisham’s lack of support for many of our progressive issues, we do not agree with the latest attacks by her Democratic rivals concerning her involvement with Delta Consulting, the high risk pool management firm. From what we have learned, these accusations are misleading and unfounded. Yes, there is a not very significant discrepancy in the fiscal reporting and some questions about how the contract was obtained but the political debate should be about issues that most impact the lives of New Mexicans, given the dismal condition of our state after 8 miserable years of Republican corruption, incompetence and non-governance. There are plenty of unanswered questions PDACNM has for Rep. Lujan Grisham, but her Democratic rivals are not asking them. For example, why has she not co-signed  H.R. 676 : Expanded and Improved Medicare for All Act.  This kind of legislation would do away with obscenely expensive medical costs and leave less need for companies like Delta Consulting.  Let’s talk issues and message.
Laura Stokes

Following is a statement by Dr. Nandini Kuehn Ph.D., MHA. She worked in NM for fifteen years as an independent Health Care Consultant.  This statement clarifies the need for the pool that Politico challenges.

“There is a story circulating right now on Politico here that makes some serious accusations against Michelle Lujan Grisham and her involvement with Delta Consulting which manages the high risk pool.  The story then attacks and calls into question the need for such a pool.  First, a portion of the pool’s enrollees are among the sickest and most expensive patients in our state. Once the ACA kicked in, anyone on the pool who was there because they were denied coverage for pre-existing conditions moved to the regular insurance pool on the Exchange. So the people who were left include the sickest and or the undocumented who are a substantial portion of the pool.  The Board is composed of consumers and experts from insurance plans who understand the financial risk this would pose to a small state and the small numbers on the NM Exchange.   Pool members with high risk, complex conditions cost tens of millions of dollars (this from a Board member of the pool who knows).  Dumping them into the Exchange general enrollment population would be a disaster for insurance plans that they might sign up with. And most importantly, the high intensity needs of these patients would get lost in the shuffle.  In this highly managed pool, their care is monitored and they are managed for the complexity of their condition.

As an insurer, Medicaid shares in the cost of the pool. The 43 million dollar savings to the state is grossly misstated by the author of the article, as every dollar that Medicaid puts into the pool generates 9 from the federal government back to the state!Most of the money that pays for the pool goes for staff and clinical management of the patient needs, not to the owners of the company.

Who does the story serve?  There is no attempt to claim that eliminating the pool would be better for the high-risk individuals whose needs, as said earlier, would get lost if they were subsumed into the Exchange.   It doesn’t serve the state which could lose Exchange carriers, nor the Exchange members who without the help of the Pool would pay much more in premiums.  Clearly it is a hatchet job on a candidate for Governor, and given the facts, the bias of the uninformed reporter who did not do adequate research has to be called into question.  Is she a Pearce mole?”

We do not need to be reminded that Steve Pearce will be a disaster for NM.

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PDA CNM DIGEST June 4, 2018

2 thoughts on “PDACNM NEWSLETTER June 4, 2018

  1. Thanks for the clarification. I became progressively more disappointed in Jeff Apodaca for his negative campaigning and for his failure to stand up for womens’ right to provide informed consent for safe and legal medical treatment, a right that men take for granted, and the denial of which they would express outrage were anyone to attempt to curtail it.

    Now let’s stand behind our Democratic candidate and promote real progress, that is, a progressively improving future for all New Mexicans.

  2. Thanks for explaining this. How does it differ from the UNM CARES program?

    Isn’t there another group that isn’t covered by Medicaid, and so needs a pool like this? I read that legal immigrants can’t apply for Medicaid until they have been here for 5 years.

    I’m looking forward to a Governor who believes in the ACA and doesn’t try to sabotage it. Who wants what’s best for the people of New Mexico.

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