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Doña Ana HHS weighs vouchers to help uninsured buy coverage; commissioners seek targeted pilot
Summary
Health and Human Services presented options to use the Health Care Assistance Program (HCAAP) to help some residents pay insurance premiums and out‑of‑pocket costs under House Bill 45, but staff warned covering the entire enrolled population would be prohibitively expensive. Commissioners asked for targeted options, metrics and an amended resolution to return in a follow‑up work session.
Jamie Michael, representing Doña Ana County Health and Human Services, updated the board on the Health Care Assistance Program (HCAAP), which the county administers under state statute and county resolution. Michael said the program covers specific services (primary care, dental, behavioral health, limited physical therapy, ambulance transports and cancer treatment at Memorial Medical Center) and is funded in part by a grocery receipts tax increment; fiscal year 2024 expenditures were about $8.6 million.
Because of House Bill 45, counties may now use HCAAP funds to help people obtain insurance—paying premiums, copays or other out‑of‑pocket costs. Michael and staff presented enrollment and utilization data: about 4,000 enrolled (35% dental‑only), roughly 10,662 medical encounters in FY25 with ~3,000 primary‑care visits; primary‑care services are delivered mainly by three federally qualified health centers (Ben Archer, La Clinica and Amador). Top primary‑care diagnoses included hypertension, immunizations and diabetes‑related conditions.
Staff warned that paying full premiums for all enrollees would cost tens of millions of dollars and is infeasible. They suggested targeted strategies: vouchers that let individuals access sliding‑fee discounts through the New Mexico Medical Insurance Pool, a county sliding fee for a capped pilot population, or focusing assistance on people with chronic illnesses requiring ongoing specialty care (e.g., dialysis or cancer treatment). Jamie said Norberto's team can provide detailed diagnosis and procedure‑code data and the annual program report for commissioners to review.
Commissioners asked for a work session and more metrics (contractor payment breakdowns, RFP scoring and utilization data). Public commenter Yoli Diaz urged clearer resolution language (Resolution 2023‑68) on eligibility, reporting and navigation services, and called for mid‑year and year‑end reporting to the BOCC. Jamie said staff will prepare an amended resolution and return with an expanded data package and recommended options in late January or a work session before a final resolution in February.
