States, tribes scrambling for medical care insurance ahead of Trump apocalypse

Military personnel love TRICARE, veterans mostly like the Veterans Health Administration and most Native Americans won’t support a copay because We the People are responsible for their medical care by treaty.

New Mexico has a high number of people with insurance through Medicaid and like South Dakota many are American Indians. Of the 342,000 patients who visited the emergency departments of the three biggest New Mexico medical providers in 2015 forty percent were Medicaid patients. 

Then during the Trump Virus pandemic New Mexico boosted its study of single-payer medical care. Now with the Orange Julius threatening healthcare again lawmakers are considering the expansion of Medicaid that could extend coverage to most New Mexicans under 65 providing insurance for an additional 80,000-85,000 patients and increasing reimbursement rates for medical providers. 

As part of the most recent study the Kaiser Family Foundation used 2023 numbers that showed 33% of New Mexicans were covered by Medicaid and 10% of New Mexicans were uninsured. New Mexico pays 28% of Medicaid costs and the federal government funds the rest under provisions of the Affordable Care Act or Obamacare.

That proposed plan, Medicaid Forward, could decrease the uninsured population by 48%. It has gained increasing support from health professionals and has been championed by the coalition New Mexico Together for Healthcare. [‘Overwhelming support’ for Medicaid Forward will lead to bill in upcoming legislative session]

Two bills addressing Indian Health Service shortfalls had been working their way though Congress.

But tribal leaders, health officials, and a new federal report say patients are routinely billed anyway as a result of backlogs or mistakes from the Indian Health Service, financial middlemen, hospitals, and clinics. Those sent to collections can face damaged credit scores, which can prevent them from securing loans or require them to pay higher interest rates. In some cases, hospitals or collection agencies hound tribal citizens for more money after bills are paid. Melanie Egorin, an assistant secretary at the U.S. Department of Health and Human Services, said at the hearing that the proposed legislation doesn’t include consequences for “bad actors” — health facilities that repeatedly bill patients when they shouldn’t. Donald Warne, a physician and member of the Oglala Sioux Tribe in South Dakota, called the proposed legislation a “band-aid.” He said the ultimate solution is for Congress to fully fund the Indian Health Service, which would reduce the need for the referred-care program. [Native American patients sent to collections for debts the government owes]

I like the idea of rolling the funding for Obamacare, TRICARE, Medicare, the IHS and the VHA together then offering Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax. Reproductive freedoms should be included just like the military does under TRICARE.

Learn more at NPR.

United Healthcare @UHC just denied a claim on one of my patients in the ICU with:

-- a brain hemorrhage
-- in a coma
-- on a ventilator
-- in heart failure

...because I haven't proven to them that caring for her in the hospital was "medically necessary".

Tear it all down.

— Zachary D Levy MD 🇲🇦 🇨🇮 (@ZLevyMD) December 31, 2024