Governor calls for health insurance reforms

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By Roger Snodgrass

SANTA FE – Gov. Bill Richardson wants to put a cap on insurance companies’ share of health premiums and end exclusions for applicants with existing medical conditions.


But reflecting current economic and political constraints, the administration’s bundle of piecemeal health care proposals that were announced Monday stop short of the comprehensive solutions that the governor has tried to pass in previous years.


The goal remains to cover “all New Mexicans,” said Bruce Perlman, the governor’s deputy chief of staff, who placed the current proposals in a context that began five years ago and featured a series of task forces and commissions whose studies and recommendations have not borne fruit.


“In the last two sessions, the legislature and the governor have not come to agreement,” he said.


During a media briefing in the Capitol, Human Services Department Secretary Pamela S. Hyde introduced components of the current health agenda in three general categories, along with an additional measure for promoting future cooperation with the legislature.


“That bill is still in development,” she said, describing it as a path forward that would avoid some of the arguments and appointment-power disputes that led to failure in the last two sessions.


That approach, she said, would create “no new bureaucracy,” and “no new commissions,” but would enable the governor and the legislature to work together to get more affordable coverage.


In the reform package, five individual bills fall under the label of insurance reform and collectively aim to get more coverage out of health insurance companies.


One of these would require insurers to spend at least 85 percent of their income from insurance premiums on actual health services.


“These companies shouldn't have the right to choose only healthy clients and reject those with pre-existing medical conditions,” Richardson said in his State of the State address for the session on Jan. 20.


The administration proposal responds by requiring health insurance companies to offer coverage to all applicants without exceptions for pre-existing conditions.


Another reform measure addresses the discrepancy of coverage for domestic partners by requiring insurance companies doing business in New Mexico to offer a plan for businesses that wish to provide coverage for the domestic partners of their employees.


One of the nine specific bills authorizes setting up and administering electronic medical records, modeled after the federal Health Insurance Portability and Accountability Act.


The three bills in this category focus on consolidating and streamlining the state government’s own health coverage bureaucracies, programs and services.


In the last session, the governor’s bill, the Health Solution Act, which endorsed the role of insurance companies as a necessary part of the solution, was not the only proposal.


Another proposal was the Health Security Act, which would have covered all the citizens of the state by placing them in a single insurance pool to extend universal coverage and lower risk.


This alternative would rely on private insurance, as in the Medicare model, as a supplemental tool.


Sen. Carlos Cisneros, D-Los Alamos, Rio Arriba, Santa Fe and Taos, said Tuesday that he was not opposed to reforms, but that he would carry the Health Securities Act again this year.


“The big problem is the lack of funding for any kind of health care initiative,” he said, not to mention that the Health Security Act “brings out heavy and effective opposition from the insurance companies.”


Despite the odds, he said he would introduce the alternative bill again, “because I believe in it.”