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Panel adopts amendment, then rolls behavioral-health Medicaid waiver bill for more work after debate over feasibility and timing
Summary
House Bill 70 would direct the Health Care Authority to pursue a Medicaid waiver to expand long-term home- and community-based services for people with serious mental illness, substance use disorder or brain injury; the committee adopted a technical amendment and then rolled the bill for further work after testimony from Medicaid staff.
House Bill 70, the Behavioral Health Medicaid Waiver Act, would require the Health Care Authority to prepare and submit a federal Medicaid waiver application to expand long-term home- and community-based services for people with serious mental illness (SMI), emotional disturbance (SED), substance-use disorders (SUD) or brain injury.
An amendment (231,647.1) struck the appropriation from the bill; presenters said funding for an initial feasibility effort exists elsewhere in the budget. The Health Care Authority’s Medicaid director, Dana Flannery, testified in opposition to the bill as written but supported a funded feasibility study, noting New Mexico currently operates several waiver vehicles and that waiver approvals and negotiations with federal partners can be lengthy. Flannery said the state recently completed a multi-year renewal for an 11 15 waiver and is negotiating an SMI/SED waiver; she warned of delays in federal approvals and recommended the feasibility study as a next step.
Supporters and advocates urged the committee to proceed. Ellen Pines of the Disability Coalition said the Medicaid program currently fails to meet needs of people with behavioral-health disabilities and supported pursuing a specialized waiver modeled on the developmental-disabilities waiver. Jim Copeland of the Association of Developmental Disabilities Community Providers noted that some people dually diagnosed with developmental disabilities and behavioral-health conditions fall between eligibility lines and could benefit from a new waiver vehicle.
Representative Vincent and others pressed officials about guarantees of federal match and what would happen if the federal approval or funding did not materialize. Health-care presenters said waiver approval would make services part of Medicaid with state and federal cost shares; if federal approval were denied, the state could limit the number of people served under a waiver model and would be responsible for state share decisions.
Action: The committee adopted an amendment that struck the appropriation and then voted to roll the bill for further work; Director Flannery and other Health Care Authority staff will continue discussions with legislators and the LFC. The committee chair said funding for a feasibility study exists elsewhere in the budget and proposed to return the bill later in the session.
Why it matters: Advocates said a behavioral-health waiver could extend community-based long-term services to people who currently lack an appropriate Medicaid eligibility vehicle; Medicaid leadership cautioned the committee to rely first on a feasibility study to map existing services, waiver overlaps and federal pathways.
