Health Care Issue

The three main government programs that provide health insurance to members of the public are Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP).

MEDICARE

Health Insurance for the aged is popularly known as Medicare. Since it was enacted in 1965, Medicare has provided health care security to millions of America's seniors and people with disabilities. Medicare has traditionally consisted of two parts: Hospital Insurance, also known as Part A, and Supplementary Medical Insurance, also known as Part B. A new, third part of Medicare, sometimes known as Part C, is the Medicare + Choice program. This program has expanded beneficiaries' options for participation in private sector health care plans.

Senator Domenici is committed to modernizing and improving Medicare. On June 27, 2003, the Senate passed S.1, the "Prescription Drug, and Medicare Improvement Act of 2003." Domenici voted in favor of this bill because he believes that it will help provide seniors with the preventative care and new medicines that are transforming health care in our country.

In addition to the prescription drug benefit, S.1 also addresses rural health care equity, helping to end Medicare's historic discrimination and unfair reimbursement rates for rural health care providers. The current Medicare reimbursement system creates a disincentive for health care providers to practice medicine in rural areas, and this affects young and old alike. Improved health care provider reimbursements will help ensure that New Mexicans have access to the best possible health care.

MEDICAID

Medicaid provides medical assistance for certain individuals and families with low incomes and resources. The program is a jointly funded cooperative venture between the Federal and State governments to assist States in the provision of adequate medical care to eligible needy persons. Medicaid is the largest program providing medical and health-related services to America's poorest people. Within broad national guidelines which the Federal government provides, each of the States:

  1. Establishes its own eligibility standards;
  2. Determines the type, amount, duration, and scope of services;
  3. Sets the rate of payment for services; and
  4. Administers its own program.

In New Mexico, all children through age nineteen are covered by the Medicaid program if their families' income is at or below 185% of the Federal Poverty Level (FPL). In January 1999, due to additional funds provided by the State Children's Health Insurance Program, coverage was expanded to children through age 18 with family income from 186-235% FPL. New Mexico also covers aged, blind, and disabled adults and children that receive benefits under the Supplemental Security Income Program (SSI.)

Recent attention has focused on the fiscal situation of the states as a number of states report that the growing costs of Medicaid are creating a burden on their budgets. This session, Domenici voted in favor of S. Con Res. 23, the Senate Budget Resolution, which does not include any cuts to Medicaid. He also supported the jobs and tax relief package. This package provides an additional $74 million to New Mexico in Medicaid FMAP (Federal Medical Assistance Percentage) funding. FMAP is the federal government's share of a state's Medicaid expenditures.

State Children's Health Insurance Program (SCHIP)

The 1997 BBA created a new block grant program, the State Children's Health Insurance Program (SCHIP). S-CHIP is designed to cover uninsured children whose parent's income is within 50 percentage points above their states Medicaid eligibility. In 1995, New Mexico made all children below 185% of poverty eligible for Medicaid. S-CHIP in New Mexico therefore covers those uninsured between 185% and 235% of the Federal Poverty Level.

Under current guidelines, S-CHIP funds can only be used to cover those children whose parent's income is within 50 percentage points above their states Medicaid eligibility. Any unused portion of S-CHIP funds must be returned to the federal government so that they can be redistributed to states that have used their entire allotment. New Mexico has only 6,000 uninsured children between 185% and 235% of poverty, while there are some 94,000 children who are below 185% of poverty but not enrolled in Medicaid. New Mexico estimates that they only spend about $3 million of the more than $50 million appropriated annually under S-CHIP.

Senator Domenici believes that the current funding structure of S-Chip must be modified to reflect the realities of the program. States should be allowed to use unspent S-CHIP funds from past fiscal years on children that do not fit into the current S-CHIP program, but are nevertheless uninsured. Domenici has been very supportive of waivers such as the Health Insurance Flexibility and Accountability initiative (HIFA) which allows the Secretary of Health and Human Services to waive federal requirements to allow states to try new approaches to delivering services. New Mexico is one of only five states to have an approved HIFA waiver.

For more information on Senator Domenici's views and activities on health care, visit our online News Center.

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