Health Care
Rep. Lujan Grisham visits patients at the Veteran Affairs Hospital in Albuquerque, NM (February 2018)
Our health care system is failing American families
We have an obligation to come together and address the two main issues in our health care system: cost and coverage. Read my op-ed in the Albuquerque Journal.
In the meantime, we must continue to defend and improve the ACA
I have opposed efforts to undermine or repeal the Affordable Care Act (ACA), which would destabilize our health care system and put millions of Americans at risk.
In May 2017, the House passed the American Health Care Act in an attempt to repeal the ACA. The non-partisan Congressional Budget Office (CBO) estimated that the bill would have led to 24 million more uninsured Americans by 2026. It also would have cut Medicaid by $834 billion over ten years and raised premiums by 15-20% this year. While the Senate fortunately voted down full ACA repeal, Congress repealed the individual mandate in its tax reform bill late last year. The CBO estimates that this repeal will increase premiums by 10% and will increase the number of uninsured Americans by 13 million by 2027.
Rather than continued efforts to undermine the ACA, the American people deserve a substantive, bipartisan debate about how to improve our health care system. It is time for both parties to come together and work to lower costs, increase access, and improve quality. I am open to any proposal that promotes these goals, including an expansion of the Medicare program. While we work toward these goals, I am acutely aware of the need to invest in our health care infrastructure, build a workforce development pipeline for health care providers, and protect the gains made as a result of the ACA’s Medicaid expansion. I believe that there are a several ways to achieve those goals, and I remain open to a broad range of solutions.
Long-Term Care
As a caregiver for my mother, I know that improving long-term care is not only a health issue. It's an economic issue, it's a jobs issue, it's a dignity and quality of life issue. Solving the looming long-term care crisis is also a way to protect and strengthen the economic security of women and minorities, who often end up becoming caregivers for their families. Roughly 70 percent of Americans turning age 65 will require long term supports and services at some point in their life, and very few Americans have the financial means to cover costs associated with that care. Our country has a moral and fiscal obligation to address the challenges we face in financing care for our aging and disabled population.
Care Corps Demonstration Act
By 2030, there will be more than 72 million older Americans, making up 19% of the total population. As they age, many of these seniors will require long-term supports and services, placing a huge burden on a fragmented system that is already struggling to provide and finance care for current seniors and individuals with disabilities who want to remain independent and receive services in their homes and communities.
- Authorizes grants for local Care Corps programs at $10 million per year over five years.
- Places Corps volunteers in communities where they will provide services that help seniors and individuals with disabilities remain independent.
- Provides volunteers with health insurance and other benefits during their time of service, along with an educational award that can be used to pay education costs or loans.
- Creates an opportunity for intergenerational relationships.
Affordable Care Act Resources
Benefits of the Affordable Care Act
- You can’t be denied coverage for pre-existing health conditions.
- Your child can stay on your health plan until age 26.
- Your health insurance company can’t cancel your health insurance just because you get sick.
- You may be eligible to receive financial assistance to help you pay for your coverage.
- You have a choice between different types of health plans with easy to use comparison tools.
- You are guaranteed the right to appeal your health insurance company’s payment denials.
- Women cannot be charged more than men for the same health coverage.
- Most health plans must offer a set of preventative care services at no cost to you.
- Health insurance companies must spend 80% of their premiums on beneficiaries; no more than 20% may go toward administration and profits.
- New Mexico has the some of the lowest health insurance rates.
- Much more!
Important Resources
- New Mexico Health Insurance Exchange (NMHIX) — New Mexico chose to create its own insurance marketplace where individuals and business can shop for health insurance, apply for financial assistance, and receive help filling out forms and assessing options. You can also shop the marketplace by calling 1-855-99-NMHIX (1-855-996-6449). For this year, individuals in New Mexico can use Healthcare.gov to shop and sign up for health insurance.
- Find Local Help — To find enrollment assistance and understand your health insurance options, make an appointment with an Enrollment Counselor or a registered New Mexico Health Insurance Exchange agent or broker near you.
- Veterans and Military Health Care — The health care law does not change VA health care of TRICARE benefits or out-of-pocket costs.
- Indian Health Care — The Affordable Care Act includes special provisions for American Indians.
- Small Businesses — The New Mexico Small business Health Options Program (SHOP) simplifies the process of buying insurance for small businesses and their employees.
- Medicare — The Affordable Care Act expanded Medicare benefits, including free preventative services and, if you are in the prescription drug “donut hole”, discounts on brand-name prescription drugs.
- Medicaid — New Mexico has expanded its Medicaid program to cover households with incomes up to 138% of the federal poverty level. That works out to about $16,750 a year for 1 person or $34,600 for a family of 4. If you're eligible, you get free or low-cost care.
- Children’s Health Insurance Program — The Children’s Health Insurance Program (CHIP) provides health coverage to nearly 9 million children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage. The Affordable Care Act strengthened CHIP by providing additional funding and maintaining CHIP’s eligibility standards.
- File complaints involving grievances with insurance companies at the New Mexico Office of Superintendent of Insurance.
Want More Information?
- My office
- (505) 346-6781
- www.lujangrisham.house.gov
- www.healthcare.gov/contact-us/
- Frequently Asked Questions
- Live Chat
- Link to New Mexico resources and information
- 1-800-318-2596 (TTY 1-855-889-4325)
- Customer Service available 24/7
Related Files
- Jeremy Sanchez Social Security Disability Insurance Fairness Act
- Support Medicare, Medicaid, Social Security
- Hispanics & Healthcare Fraud
- Sexual Reproductive Health Internationally
- MPFS proposal to cap payment rates at Hosptial OPPS
- Updating Medicare PFS rates and policies for CY2014
- Support the Special Diabetes Program
- Proposed 2014 HHPPS rule to cut Medicare Home Health Funding
- RWJF Center for Health-Congressional Tri-Caucus Health Disparities Summit
- New Mexico Behavioral health providers investigation ramifications