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We now have a New Mexico Health Insurance Exchange board named by both the governor and the Legislature. Key up the band to play a rousing march.
As usual, New Mexico is toward the end of the parade, but we have the luxury of learning from states that have gone before.
The board’s job, under the Affordable Care Act, is to set up a marketplace where individuals and businesses can shop for health insurance, compare price and coverage, and purchase plans from private insurers — a kind of Amazon.com for insurance.
The painstaking balance of this board and the nature of the exchange are the products of a lot of wrangling. State lawmakers worked on a bill for two years only to have it vetoed by the governor, who took the process away from them. After a year of unproductive plodding by the administration, the Legislature this year took it back, cast aside two bills and settled on a third, which was a compromise measure.
The big issues: Who, exactly, would sit on this board and how would they be chosen? And would the exchange itself be governed by the state or the marketplace?
Freshman Sen. Benny Shendo, a Democrat from Jemez Pueblo whose bill won the day, gave the governor and the Legislature six appointees each on the board; the superintendent of insurance is the tie breaker. He also wanted to create a framework that could accommodate change. The governor and Republicans thought two other Dem bills gave government too heavy a hand and wanted a market approach. Shendo agreed.
While the governor heaped praise on her own party and all but ignored Shendo’s major role, let’s acknowledge several facts: Shendo has a business background, he’s no stranger to insurance, and he’s comfortable with a market approach. Also, Sen. Jerry Ortiz y Pino, an Albuquerque liberal whose exchange bill was doomed, handed the baton to Shendo and then helped deflect criticism from the left that they threw out low-income people and gave industry what it wanted.
“This is the start of a process, not the end of it,” said Ortiz y Pino. “We will make sure this doesn’t ignore the consumer. I fully believe we will revisit the exchange every year for 10 years, and it will evolve. I’m not a great believer in the divine hand of the free market — I can’t believe I’m about to say this — but I do believe in the power of competition to keep prices affordable.”
Said Shendo: “We take to heart all the comments. I represent the poorest of the poor. Those folks in my constituency are dear to my heart. We will find a way to help them.”
This is why the exchange must offer a statewide consumer assistance program, consumer complaint and grievance procedures, and alternative dispute resolution. The board can create a Native American Service Center to help with outreach and communications.
We should now let the board and the exchange work, but the political climate being what it is, there’s a steady torrent of calamitous predictions in the media, followed by reassurances from authorities.
Most of us are in no position to judge, so we have to remind ourselves that we reached this point because the existing system doesn’t work. When one in five New Mexicans, more than 400,000, lacks insurance, that’s a failed system. When the sickest of the uninsured overload the emergency rooms, that’s a failed system. When you yourself can lose your coverage or be denied coverage for any reason, that’s a failed system.
Obamacare may be flawed, but it’s the compromise Washington gave us, and it can be modified. As an expert from the Robert Wood Johnson Foundation told lawmakers, “Despite the rhetoric, I can’t find a state where everyone rejects the law.”