San Juan County opposes Medicaid payment increase

The County Commission unanimously passed a resolution opposing a proposed bill that would increase the payments to the county-supported Medicaid fund

Hannah Grover
San Juan County

AZTEC — Members of the San Juan County Commission are concerned that proposed legislation at the state level could mean the county has to pay more to the county-supported Medicaid fund.

During a meeting here today, commissioners unanimously approved a resolution stating opposition to House Bill 490, which was introduced by Rep. Jimmie Hall, R-Bernalillo. The measure would require the state's counties to transfer additional revenue to the county-supported Medicaid fund in varying amounts four times a year.

"Citizens should be prepared that, if it passes, there will be a tax increase," County Executive Officer Kim Carpenter said, referring to a provision in the bill that allows counties to implement a gross receipts sales tax to cover the additional cost.

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When reached by phone today in Santa Fe, Hall said the county could use money from existing funds — such as the indigent care fund — to cover that cost rather than raising taxes.

Rep. Jimmie Hall, R-Bernalillo

In 2014, a Medicaid expansion went into effect, causing enrollment in the program to grow by more than 46 percent, according to the fiscal impact report. The report states that many of the people who took advantage of the expanded program were previously served by the county indigent programs. While Medicaid relieved the burden on indigent care funds, the counties' contributions to the county-supported Medicaid fund remained flat, according to the report.

Carpenter said the county did not see significant relief from the expanded Medicaid program and has seen an increase in jail inmate claims, which are not covered by Medicaid. Carpenter said a decline in indigent health care claims was caused by the county implementing stricter restrictions for claims rather than expanded Medicaid.

Hall said San Juan County currently has $6 million in indigent fund reserves, an amount that increased by $1 million in the last year.

"You have a build-up of $6 million, and my question is why," he said.

Hall said that money could be used to pay for health care at the San Juan County Adult Detention Center or for substance abuse programs.

"If (those funds are) being used, I don't want to bring it back to the state," Hall said.

Carpenter said the numbers that Hall cited about the county's indigent fund are inaccurate. He said the reserve balance is less than $4 million, and it is being depleted. Carpenter said over the past two years, the reserve balance has has decreased from $9 million, and he estimated it will be exhausted by fiscal year 2019.

"The bottom line is that thing will be down to zilch much faster," he said.

Hannah Grover covers government for The Daily Times. She can be reached at 505-564-4652.