- Associated Press - Sunday, July 19, 2015

ALBUQUERQUE, N.M. (AP) - More than a dozen states that opted to expand Medicaid under the Affordable Care Act have seen enrollments surge way beyond projections, raising concerns that the added costs will strain their budgets when federal aid is scaled back starting in two years.

New Mexico is among those states. Here are some things to know:



When New Mexico first considered expanding the Medicaid program, the state Human Services Department projected more than 191,000 people would be added to the rolls by 2020. That number already has been reached. More than 216,600 people have been added to the rolls, bringing the total to nearly 800,000. That’s almost double the number a decade ago. By 2020, total enrollment is projected to be approaching 900,000.



The costs have more than doubled too. A recent report issued by the Legislative Finance Committee says New Mexico can expect to spend more than $1.1 billion in general fund dollars on the program during the 2020 fiscal year. The committee has warned that the growing price tag for providing health care to low-income New Mexicans will put more pressure on the state’s finances unless steps are taken to control costs.



Officials say the point of modernizing the Medicaid system was to slow down the rate of growth in the program while avoiding cuts. By combining existing programs and Medicaid expansion allowed for as part of the federal government’s health care overhaul, officials initially projected a cost savings of more than $450 million. That estimate has now been rolled back to $253 million.



State officials say more money is being spent on direct services rather than administration under New Mexico’s new Medicaid system, which is called Centennial Care. But among the recommendations outlined by the Legislative Finance Committee, is that New Mexico needs to impose more controls to ensure it negotiates rates with managed care organizations that are on the lower end of the range. For example, had lower rates been negotiated for 2014, the Human Services Department could have saved as much as $28 million in general fund dollars.



The agency says it has made important progress in improving access to health care - particularly for vulnerable populations - and no eligibility changes are planned despite the rising costs. Agency Secretary Brent Earnest said the program has “undergone historic change” and it’s too soon to think about changing course since the available data isn’t enough to paint a complete picture about the costs or how recipients are using the system.

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