- Associated Press - Wednesday, October 26, 2016

SANTA FE, N.M. (AP) - New Mexico is pursuing federal authority to charge medical co-payments and some other costs to patients enrolled in Medicaid health care for the poor and disabled, the state Human Services Department secretary told lawmakers on Wednesday.

Secretary Brent Earnest said “nominal” co-payments and other charges would provide a small economic incentive to steer patients away from wasteful expenses, such as the use of emergency room services for routine care.

Earnest said the agency has not yet established copayment prices for Medicaid services and certain prescription drugs, or determined how much money the state might save over time.

Federal rules limit cost-sharing on Medicaid to patients who are not in extreme poverty. The state wants to exempt children and pregnant women, along with Native American patients who typically receive Medicaid benefits through Indian Health Service and tribal health care facilities.

New Mexico has one of the highest Medicaid enrollment rates in the nation, and the state is grappling with how to pay its share amid a budget crisis linked to an oil industry downturn. The state’s credit rating was downgraded this week by Moody’s Investor Services based on low general fund reserves.

The federal government is gradually reducing its share of Medicaid matching funds for adults who enrolled under the 2014 expansion.

Annual Medicaid program spending in New Mexico is projected to exceed $6.1 billion next fiscal year. The state’s share of those costs is expected to increase by about $80 million to just over $1 billion, Earnest said.

Per-capital Medicaid costs under the state’s managed care system dropped by 1 percent during the year ending in March, Earnest said. Enrollment climbed 10 percent during the same period.

Children account for about four in 10 Medicaid patients in New Mexico.

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