Opinion: Here's what you're getting for your state health care dollars
We at the New Mexico Human Services Department presented our proposed budget of $7.78 billion for fiscal year 2021 to the Legislative Finance Committee on Oct. 30. Sen. Steven Neville, R-San Juan, used the word, “mind-boggling” when referring to health care costs, and commented on our budget request saying, “It’s bigger than our state budget.”
We certainly expect the Legislature and the people of New Mexico to ask, “So what are we getting for $92.8 million more?” — which is the increase for 2021. Just because we’re a government agency doesn’t mean we’re exempt from proving there is a substantial return on the investment of state and federal taxpayer dollars. In fact, we believe that this is an investment that any individual or business in New Mexico would be willing to make were they in our shoes. Here’s why.
• New Mexico receives a federal match of $3.65 for every $1 of state general fund we spend on Medicaid. We have 850,000 low income people in our state whose health care costs are covered by Medicaid.
• The Supplemental Nutrition Assistance Program (SNAP) provides food to over 450,000 children and adults. It is sponsored entirely with federal dollars.
• The Temporary Assistance to Needy Families (TANF) provides income for 27,500 very low-income New Mexicans, receives over 99 percent of its funding from the federal government.
Think about this:
New Mexico has the third-lowest per capita income and the third-highest poverty rate among US states. Consequently, our state’s Medicaid program receives a mathematically appropriate match in federal funds for some of our most important programs.
New Mexico ranks number one nationally in hunger and food insecurity for both children and adults. Over a quarter of our children wake up every morning knowing that they won’t have enough to eat that day. In some counties it is more than one-third of our kids. In addition to this being incomprehensible, it is unacceptable.
SNAP “Heat and Eat” is a new federal program that allows New Mexico to pay $21 per year in energy assistance payments for 40,000 low income SNAP families. It increases the allowable income deduction for each household, qualifying them for an extra $480 in food benefits per year. That’s an additional $19 million in federal funds for our state, which is enough to pay for an additional 6,867,715 meals per year, with most of that money flowing through grocery stores and Farmer’s Markets. We are asking for an additional $1.5 million in this budget request (includes IT set up costs), but after that the $840,000 annual investment keeps bringing back $19 million in federal funds every year.
In addition to providing these and/or other services to over half of our state’s population, we also provide comprehensive behavioral health care coverage to those with severe mental illness and coordinate our state’s child support program, which ensures that over $130 million gets to children in New Mexico every year so that kids can grow up being kids.
And did you know: we are on a mission to substantially enhance the effectiveness of our child support system? A recent pilot in Rio Rancho showed that for every additional dollar we invest in helping parents find employment, an additional $4.54 gets sent to kids. We want and need to spread that across the entire state.
Our requested increase would also cover:
• Information technology advancements to reprogram our state enrollment system to increase accurate administration of benefits.
• Additional IT employees to ensure the successful on time completion of our massive $230 million Medicaid computer system replacement.
• A program to provide 18 months of modest extra income to TANF recipients who return to work, so they don’t immediately lose SNAP and Medicaid benefits and end up economically worse off than when there were unemployed.
In summary, HSD has worked hard to produce a budget that makes the wisest possible investment of every taxpayer dollar. Investments in these programs pays the ultimate dividend of lifting people out of poverty and into to satisfying careers (for whom it is possible). We have also been wisely directed by our governor to ensure that that every dollar that has a federal match stays right here in the New Mexico economy.
If we had a personal investment that guaranteed somewhere between $3.65 and $21 for every dollar we put in, we’d be withdrawing our lives’ savings and investing it now instead of writing this article. Each of you would likely make the same choice, and so should New Mexico.
David R. Scrase, M.D., is the Human Services Department cabinet secretary.