By now, you’ve seen Politico’s story on Democratic gubernatorial frontrunner Michelle Lujan Grisham and her affiliation with Delta Consulting, an entity that administers a little-known state health insurance program.
If you haven’t, it’s a worthwhile read.
The Politico story frames the legislation, which stalled late during last year’s session, around Lujan Grisham’s past business association with Democratic state Rep. Deborah Armstrong, who heads up the Legislature’s House Health and Human Services Committee.
Lujan Grisham and Armstrong were principals in Delta Consulting, which is contracted by the state to run the New Mexico Medical Insurance Pool.
According to the Office of the Secretary of State, Armstrong currently is listed as president on Delta Consulting’s corporation profile. Lujan Grisham is not mentioned. Politico reports the Democratic gubernatorial frontrunner sold her stake in the company last year.
The House Health and Human Services Committee tabled House Bill 316 last year, effectively killing it.
The legislation would have reduced the size of the state’s high risk pool, the largest state contract for Delta Consulting, Politico reports.
The Politico report seems to suggest that the debate over the bill in 2017 fell along partisan lines, and that its demise was due to Democrats, including Armstrong, on the Health committee. But events surrounding the 2017 debate, and the committee discussions at the time, show it was much more complicated.
Read NMID’s 2017 report here
A coalition of small business and health care advocates, as well as Democratic and Republican lawmakers, worried about the legislation’s potential far-reaching consequences at a time when the future of healthcare in New Mexico and around the country seemed fuzzy at best.
If you recall, Donald Trump was in the first months of his presidency and was calling repeatedly for the end of one of President Barack Obama’s signature achievements, the Affordable Care Act.
Legislative leaders in New Mexico, like Sen. John Arthur Smith, routinely expressed uncertainty about the state budget in light of not knowing what would be happening at the federal level regarding Medicaid funding.
A Republican-controlled Congress seemed to share the president’s goal to end Obamacare. At the same time congressional leaders, like Paul Ryan, were signaling to states the possibility that America’s healthcare system might significantly change should Obamacare cease to exist, including an idea for federal “innovation grants,” which would have helped states develop or strengthen high-risk pools and other programs.
Coinciding with the Obamacare repeal push in Washington was a financial crisis in New Mexico that policy makers were trying to dig out of and House Bill 316 was one of a myriad of cost-cutting proposals state lawmakers were considering.
To say House Bill 316 was complicated is an understatement. It had a lot of moving parts. There were concerns, too, that the bill would squeeze the state’s insurance markets and that small businesses would bear the burden.
The Office of the Superintendent of Insurance (OSI) in an analysis of the legislation said the insurers would pass those increased costs on to New Mexican consumers — specifically, New Mexicans who purchase health coverage in individual commercial markets and small businesses that offer coverage to employees.
“These increases will likely need to be significant in order to protect carrier solvency and ability to pay claims,” read an OSI analysis of HB 316. “OSI projects that the magnitude of this premium increase would likely cause premiums for a single individual to increase hundreds of dollars a year.”
There were estimates that nearly 100,000 New Mexicans would pay more for health insurance.
Small business advocates, in particular, expressed concerns to state lawmakers about the legislation’s effect, a concern noted by state lawmakers debating the bill at the time.
“I don’t perceive that the carriers would just absorb this cost,” Republican state Rep. Rebecca Dow said during a March 8 meeting of the House Health and Human Services Committee, according to a video archived on the Legislature’s website.
“I think this is another bill that would pass on more burden to the individuals. And we have in one sense people coming in and saying you have to vote for this bill because we don’t know what’s going to happen to the Affordable Care Act. Then those exact same people stood up today and said we can’t vote on this bill because we don’t know what’s going to happen with the Affordable Health Care Act.”
Dow said she was looking at it through the perspective of small businesses and individuals. It didn’t seem very business-friendly, she said, putting it on the little guy.
The committee tabled the bill after Dow’s comments, effectively killing it. Dow was one of those who voted to table.
Republican state Rep. Gail Armstrong (not to be confused with Rep. Deborah Armstrong of Delta), who voted against tabling the legislation, asked to explain her vote.
“I’m with Rebecca,” Armstrong said. She went on to say it’s a really big discussion that she wished the committee had more time for, expressing concern for small businesses.
The legislation seemed to produce many more questions than it answered as state lawmakers attempted to close a yawning budget gap.
Politico’s reporting raises different questions than the ones NMID addressed with the legislation last year.
We expect it to become a gubernatorial campaign issue, for many reasons.
One question NMID has in the wake of Politico’s stories: are Delta Consulting’s contracts with the New Mexico Medical Insurance Pool posted anywhere publicly?
Several searches on the New Mexico Sunshine Portal this morning did not bring up the contracts Politico based its reporting on. Another question, or more accurately — a perennial one — is whether New Mexico is well served by a citizen legislature that, by its nature, produces potential conflicts of interest. Or at least, the appearance of them.