Was New Mexico’s Medicaid expansion a failure?

A new report from the Legislative Finance Committee highlights the challenges New Mexico’s Medicaid population faces in actually accessing health care. The report plainly states that, “Medicaid enrollees do not have adequate access to timely healthcare.”

This is no surprise going back to the ObamaCare days when the distinction between expanded “coverage” and actual “access to care” was made clear by opponents and muddled by supporters.

Quoting directly from the LFC report (p. 4), “The State’s Medicaid population has grown over time and nearly half (47 percent) of the state‚Äôs population participates in the program. Furthermore, Medicaid covered an estimated 77 percent of births in 2021. Yet, the state continues to face poor health outcomes overall.”

Medicaid is the largest healthcare payer in New Mexico, and the state has the largest Medicaid program per capita in the country. Between FY19 and FY23, HSD projects total Medicaid spending to increase approximately 56 percent from $5.6 billion to $8.8 billion. In other words, by next fiscal year Medicaid alone will be spending more than New Mexico’s entire FY 2022 budget.

Interestingly, according to the report, “even though more people are covered by Medicaid and expenditures have grown, healthcare use is flat or declining, with exceptions in behavioral health and telemedicine.” At the same time “Emergency room visits for non-urgent reasons have increased, potentially leading to worse outcomes.”

As was widely reported in media outlets regarding this report Medicaid recipients don’t necessarily have access to care. This was a criticism of many who opposed ObamaCare which in essence was simply a massive expansion of Medicaid more than an actual health reform (see chart below).

And, while the report is more broadly about Medicaid as a whole, many of the problems inherent in the system are the direct result of the ObamaCare expansion which then-Gov. Susana Martinez undertook in January 2013, a decade ago (much to the chagrin of the Rio Grande Foundation). Surprisingly, or perhaps not, there was little discussion of ways in which all of this Medicaid spending has helped improve New Mexicans’ health outcomes.