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| Wilson to President Clinton: “Seniors are waiting for action” |
December 13, 2000 |
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| Albuquerque, New Mexico—As negotiations between the President and Congressional leaders continue on budget issues, thousands of New Mexicans—mostly seniors—wait to see if Medicare reimbursement rates will be increased. This issue could make the difference in whether or not they’ll be forced to find new doctors and revert to standard fee-for-service Medicare.
Congresswoman Heather Wilson yesterday asked President Bill Clinton to accept changes to Medicare reimbursement rates that will impact thousands of New Mexicans.
“I know from published reports that you and your staff have concerns about Medicare Choice reimbursement rates,” Wilson told the President. “I want to share with you why these provisions are so important to New Mexicans, particularly low-income New Mexicans.”
In mid-October, Clinton’s Chief of Staff John Podesta told reporters that he and Health and Human Services Secretary Donna Shalala had concerns about the proposed Medicare increases. Clinton himself expressed concern, but reportedly stopped short of promising a veto (Albuquerque Journal, Michael Coleman, 10/18/00 “Medicare/HMO Bill Raises Clinton Concerns”).
Medicare reimbursement rates are one of the most important issues remaining to be resolved before the 106th Congress adjourns.
“All three [Medicare Choice] providers have told their patients and the federal government that they will have to scale back or end their Medicare Choice programs effective January 1 because they cannot cover the losses,” Wilson explained to the President yesterday in a two-page letter. “I believe all three will stay if we can get the reimbursement rates to come close to the cost of providing care. That will be great news to the 15,000 New Mexico seniors who will have to go back to basic Medicare on January 1 without our help.”
“There are few things more important to New Mexico than getting some remedy to the Medicare Choice problem and strengthening Medicare more generally. I urge you not to stand in the way of letting seniors keep the health care coverage that has worked for them,” concluded the New Mexico lawmaker.
Wilson, along with Senator Pete Domenici, has led the bipartisan effort in the Congress to fix a Medicare formula that inherently discriminates against small states like New Mexico, where federal reimbursements for health care for seniors are half of what the federal government pays in other parts of the country.
Medicare Choice is the HMO component of Medicare, where participating HMO’s receive a fixed amount from the federal government for each enrolled patient. Medicare Choice reimbursement rates in New Mexico are among the lowest in the country. In New Mexico, the county with the highest reimbursement rate receives $430.44 per person per month for the Medicare Choice program. That compares with $719.23 in Texas, $729.07 in California, $794.02 in Florida, and $814.32 in New York.
As a result, three New Mexico health providers (St. Joseph’s, Presbyterian, and Lovelace) announced earlier this year that they would scale back their participation in the federal Medicare-HMO program, a decision based largely on these unfair federal reimbursement rates.
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