What will remain of the Affordable Care Act in a year or two?
Maybe very little, some New Mexico lawmakers worry.
While Democrats in the state House of Representatives have talked a lot about expanding access to Medicaid, many are also trying to hold the line on the landmark and controversial health care law also known as Obamacare, bracing for big changes as 18 attorneys general challenge its constitutionality in federal court.
House Democrats are sponsoring legislation that would write several provisions of the Affordable Care Act into New Mexico law with hopes that no matter what happens at the federal level, the state can keep in place some of the standards for covering mental health care, for example, and protections for patients with pre-existing conditions.
“We’re in that group,” said state Rep. Liz Thomson, D-Albuquerque, a breast cancer survivor whose son has autism. She is sponsoring House Bill 436.
President Donald Trump said repeatedly during last year’s mid-term election and again in his State of the Union Address that his administration would protect patients with pre-existing conditions.
But legislators here are not so sure.
In turn, House Bill 436, would put into state law the requirement that anyone who applies for a plan must be offered one regardless of preexisting conditions. And it would bar plans from charging more to patients based on preexisting conditions.
The bill, crafted with staff from the state Office of the Superintendent of Insurance, would also outline essential health benefits that plans must cover, including emergency services and mental health care.
“The people of New Mexico need peace of mind, knowing these protections will be in place no matter what happens at the national level,” Thomson said.
Other lawmakers are aiming to put some more specific provisions of the Affordable Care Act into state law: those on contraception.
House Bill 89, sponsored by Rep. Debbie Armstrong, D-Albuquerque, would require health insurance plans to cover most contraceptive medications and devices without charging patients out of pocket.
The bills follow a trend that has rippled through several states as lawmakers find ways to build portions of the Affordable Care Act into state statutes. Lawmakers in Maine, Wisconsin and Texas have filed similar bills, for example.
“There is a wave of activity at the state level, mostly geared towards protecting contraceptive coverage if the Affordable Care Act is repealed or eroded,” said Alina Salganicoff, vice president and director of Women’s Health Policy at the Kaiser Family Foundation.
Some states are also looking to go further than the Affordable Care Act, she noted.
Similarly, New Mexico legislators are also considering a bill that would allow consumers who earn too much money to qualify for Medicaid to buy a plan under the program — what’s known as a “Medicaid buy-in.”
But the state would be on its own for now to finance such a system.
And if the latest high-profile legal challenge to the Affordable Care Act prevails, the state may also have to grapple with how to help patients pay for coverage. According to the Kaiser Family Foundation, New Mexicans got about $200 million in subsidies last year to pay for insurance.
Moreover, states do not have authority over all plans, such as self-funded plans.
Still, proponents of the Affordable Care Act argue that writing some of the federal law into state statute is a step towards preserving it.