As if New Mexico needed another reason to expand Medicaid eligibility and to accept federal dollars that will bring health care to more people, we have another. Because the state is home to a large population of American Indians — more than 200,000 registered tribal members live here — Medicaid expansion would result in better access to health care for thousands of Indian citizens who otherwise might go without.
Currently, Indian citizens use their private insurance or Indian Health Services — and even with Medicaid expansion, many will continue to have insurance through their jobs. However, for Indians who live away from tribal homes and who don’t have insurance through work, it can be difficult to use Indian Health Services. In some instances, people who need care have to return home to their pueblo or reservation. Whether that means driving from Albuquerque back to a home pueblo or leaving Santa Fe to head to South Dakota, the distance between guaranteed care and a person’s residency can be a barrier to treatment. However, tribal members — like all other citizens whose incomes qualify — can enroll in Medicaid, the federal program designed to ensure that low-income citizens can receive necessary care.
What’s happening now is that the federal government is trying to expand people’s access to health care. That was an essential characteristic of recent federal health reform, especially for the nation’s most vulnerable citizens. Thus, included in the national health care law was the provision allowing states to expand Medicaid to people making 133 percent of poverty, with the federal government paying all enrollment costs from 2014 to 2016, and the federal share eventually shrinking to 90 percent. All the states have to do is sign up the eligible; under new guidelines, in a family of four earning about $32,000 a year, an adult could be covered. The expansion of this safety net would make some 25,000 Native Americans eligible to receive Medicaid, according to a recent KUNM news report.
Of course, Indian citizens are far from the only people who would benefit should New Mexico decide to expand Medicaid eligibility. (The decision is up to each state because the Supreme Court ruling that declared “Obamacare,” or the Affordable Care Act, constitutional, held that states could opt out of the Medicaid expansion. Many Republican-leaning states — Texas, South Dakota and others — want no part of the expansion despite the free federal dollars. Other states, like New Mexico, are still trying to decide what to do.) We believe that it’s essential for New Mexico, with its high level of people lacking insurance — the nation’s second-highest rate of uninsured — to expand Medicaid eligibility so that another 150,000 New Mexicans have access to health care. Gov. Brian Sandoval of Nevada, another Republican governor, recently decided to accept Medicaid expansion for the good of the people of his state. We believe Gov. Susana Martinez should decide to expand Medicaid as well — it would show her independence from partisanship, but most importantly, it would make obtaining care easier for New Mexicans from all walks of life.