Despite a shortage of primary care physicians and pediatricians in communities nationwide, I choose to work in New Mexico because I care deeply for my native home. Unfortunately, the state seems to be doing its best to discourage this choice.
My pediatric practice is in a rural area, where four out of every five kids are enrolled in Medicaid — the state/federal health insurance program for the poor. It’s a critical source of health coverage for families, my neighbors and 80 percent of kids who go to school with my children. Most of the children I care for who are covered by Medicaid have parents who work full time. They are teachers, medical assistants, perform seasonal agricultural work or have other local jobs that neither include health insurance nor pay well enough to allow them to purchase it.
The state has made deep cuts to Medicaid over the past two years. Cuts are devastating when Medicaid makes up the majority of revenue for many physicians. The budget cuts have in many ways shifted the cost of care to practitioners. It’s a disincentive for those of us who treat Medicaid patients, and it means we are essentially providing a subsidy to the state in caring for these patients. Our costs have gone up every year, but our reimbursements haven’t. Payment rates to Medicaid practitioners were reduced last year by between 2 percent and 7 percent, depending on the type of care and visit. Even with no decrease to the Medicaid fee schedule, we get a significant pay cut because inflation and our costs continually rise.