The future of health care \u2013 or at least how we pay for it \u2013 is confusing, to say the least.\u00a0 One question is what happens to New Mexico state authority under the Obamacare law.<\/p>\n
New Mexico contains quite a few mandates \u2013 services insurance companies are required to cover.<\/p>\n
For example, some years ago a prospective adoptive parent found that state regulations required health insurance for the adopted child, but insurance companies weren\u2019t covering adopted children.\u00a0 A legislator was asked for help, and a law was enacted to require that coverage.\u00a0 Hence, a mandate.<\/p>\n
Current law mandates coverage for mammograms, colorectal screenings, and a whole list of other treatments.\u00a0 Some of them are quite narrowly written \u2013 a specific treatment for a specific cancer, for example. Heartbreaking stories may lie behind some of these provisions \u2013 a badly needed treatment denied, a call to a legislator, and a new mandate written into law.<\/p>\n
Whether mandates add to the cost of insurance can be argued.\u00a0 One side says people should pay for their own routine preventive screenings.\u00a0 The opposing argument says screenings catch serious health conditions early, saving money because early treatment is so much more cost-effective.\u00a0 Early detection also prevents pain and suffering, which is measured in non-monetary values. \u00a0Experience shows many New Mexicans don\u2019t get those services unless they are covered.<\/p>\n
New Mexico law allows minimal insurance policies as an alternative, but even that provision contains mandatory coverages and, arguably, is not so minimal.<\/p>\n
Our choice in insurance plans is limited to companies willing to be accountable to New Mexico regulators for fulfilling their commitments.<\/p>\n
Which brings us to the federal Affordable Care Act:\u00a0 how it will interact with state law, who \u2013 the states or the feds — will provide regulatory backup, and a word about what could have happened if the election results had been different.<\/p>\n
A basic fact of insurance is that the consumer pays in advance for the promise that the insurance company will pay for unknown future costs. \u00a0Then it\u2019s up to the insurance company to fulfill its promise, which gives great power to insurance companies, and is why regulators are needed.<\/p>\n
A feature of Obamacare is an \u201cEssential Benefits Package\u201d \u2013 a minimum standard for what all policies must contain if sold through the state\u2019s exchange.\u00a0 New Mexico has a multi-agency task force, led by the Human Services Department, working on developing an exchange.\u00a0 According to just-retired Sen. Dede Feldman (D-Albuquerque), developing this package and building an exchange involves decisions about how to coordinate federal requirements with state law, including mandates.\u00a0\u00a0 While not everything is clear, it appears that the federal law leaves much authority with the states.<\/p>\n
During the 2012 campaign, some Republicans, including\u00a0 New Mexico Congressman Steve Pearce, argued for replacing the Affordable Care Act, and an oft-repeated element of the replacement plan would be to allow insurance to be purchased across state lines.\u00a0 While Obamacare probably won\u2019t be repealed under the current administration, this interstate idea is not necessarily dead and deserves a little examination.<\/p>\n
If health insurance were purchased across state lines, who would regulate it? Would it establish a new federal agency to replace state insurance regulators? Perhaps less protection for consumers?\u00a0 Consolidation of many insurance companies into fewer very big ones, as happened with banks when they were deregulated?<\/p>\n
Nobody I spoke to could answer this question.\u00a0 I just know that whenever consumers rely on insurance, there is a need for a regulator who can help consumers get what they\u2019ve paid for. \u00a0\u00a0The legislature will be grappling this year with moving the Insurance Department out of the Public Regulation Commission and setting up a new mechanism for choosing a superintendent.\u00a0 \u00a0\u00a0It\u2019s critical that we are able to select qualified superintendents and that we invest in a strong, pro-consumer department.<\/p>\n
\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" The future of health care \u2013 or at least how we pay for it \u2013 is confusing, to say the least.\u00a0 One question is what happens to New Mexico state authority under the Obamacare law. New Mexico contains quite a … Continue reading