The new American Health Care Act, also known as “Trumpcare,” passed hastily by the U.S. House of Representatives on May 4, will have devastating health and economic impacts on the residents of New Mexico.
We are researchers who have studied health policy. One of us has studied health care and insurance programs in rural New Mexico for 20 years. We are deeply concerned by provisions of this new health bill, which is expected to leave 24 million people uninsured by 2026. We are especially concerned about the bill’s potential effects on the nearly 700,000 (23 percent) of New Mexicans who live in rural areas.
Since the Patient Protection and Affordable Care Act, also known as “Obamacare,” was enacted and Medicaid was expanded seven years ago in the state, more than 200,000 New Mexicans were finally able to get health insurance. The Con Alma Foundation reports that as result, 71 percent of uninsured New Mexicans, including those with pre-existing conditions, were eligible for Medicaid or for financial assistance in 2014 through the individual marketplace.
Under the provisions of the new House bill, premium costs for individuals with pre-existing conditions will rise steeply, moderate- and middle-income residents may no longer be able to afford coverage, and an additional 250,000 New Mexicans will lose coverage gained from the expansion of Medicaid.
Obamacare opened up crucial resources for New Mexicans and other rural Americans, who face higher rates of mental health and substance abuse conditions than urban dwellers, by mandating “behavioral health parity.” Under the American Health Care Act, insurance providers would not be required to pay for mental health and substance abuse treatment services.
Experts predict a death spiral in the insurance market because of the American Health Care Act — premiums will soar, coverage will shrink and insurance companies will abandon rural communities. Many health care providers will find themselves out of work, and many community health centers in rural areas will be forced to close, further jeopardizing what are already fragile rural economies.
Repeal would also eliminate 31,853 jobs in New Mexico, or 38.6 out of every 1,000 jobs, and the state would lose $2.3 billion in federal health care dollars. The providers who remain in rural areas will have to care for poorer patients who will become sicker in the absence of coverage and regular care. Providers and patients in rural areas will be hit the hardest.
If the Senate passes this legislation, it will ultimately shift costs to care for newly uninsured patients to states, localities and vulnerable citizens who cannot afford coverage. Our community health centers received $145 million through Obamacare. Without the support that was provided by the Affordable Care Act, these centers will face tremendous challenges to keep their doors open for rural New Mexicans.
All New Mexicans, perhaps even U.S. Rep. Steve Pearce, R-N.M., can agree on the importance of protecting the caregiving facilities that serve us all. A sustainable health care infrastructure and access to coverage is particularly crucial to sustaining rural communities.
We must make our voices heard, here and in Washington, as the Senate currently revises this bill in secret — and before senators attempt to make it law. Otherwise, the advances made under the Affordable Care Act will be torn down, turning back the clock on the health of rural New Mexicans.
Cathleen E. Willging, Ph.D., is a resident of Bernalillo and a health services researcher specializing in the study of rural health. She is also co-chairwoman of the New Mexico Chapter of the Scholars Strategy Network. Claire Snell-Rood, Ph.D., is a resident of Berkeley, Calif., a health services researcher specializing in the study of rural health and a member of the Scholars Strategy Network.