Goal 1: Insure New Mexico

Task 1.1: Provide small employers more options for affordable health insurance

1. The SCI program became effective July 1, 2005 making adults with a family income at/or below 200 percent of FPL eligible for health insurance coverage through a Medicaid waiver program, which utilizes federal and state funding plus contributions by employers and employees on a sliding scale/income based basis.
   1. Outreach to small employers began April 2006 and will continue throughout FY 2007, with incentives for MCOs to insure groups rather than individuals.
   2. The SCI outreach program includes radio, print and outdoor advertising encouraging employers who have not offered insurance in the last 12 months to utilize SCI for their low-income employees.
2. Implement the SEIP in July, 2006 that allows employers, including non-profits, with 50 or fewer employees that have not offered insurance benefits in the previous 12 months to buy insurance through a state-sponsored and administered program utilizing the Insure New Mexico! enrollment, counseling and placement process. Development of SEIP will include:
   1. Benefit plan and premium rates;
   2. ASO agreement;
   3. Counseling and enrollment system for groups;
   4. Database design for billing and enrollment;
   5. Utilize NMMIP, SCI and SEIP together to cover all employees of any given employer;
   6. Develop plan for receivables and payables; and
   7. SEIP marketing campaign including advertising and web site.
3. Develop a marketing campaign for new Insure New Mexico! options (SEIP, premium assistance program) to engage New Mexico employers and eligible individuals.
4. Continue outreach by HIA, in collaboration with state agencies, to educate groups and individuals about insurance options (including plans offered by HIA, SEIP, SCI, NMMIP for high-risk/uninsurable individuals) to help with retention and initial purchase of insurance coverage, including availability of coverage for part-time employees and dependent children through the age of 25.
5. Develop Insure New Mexico! Call Center to assist employers access SEIP and SCI, along with HIA and NMMIP products.
6. Increase child support enforcement field office outreach to small employers regarding their rights and responsibilities in providing coverage for dependents of employees and how to work within the guidelines governing New Mexico's use of the national medical support notice. Nine new child support specialists and two attorney positions will be hired to assist in paternity establishment and medical support order establishment.
7. Support Governor's Insure New Mexico! Initiatives, including those requiring legislation in the 2007 Session.
   1. Provide medicaid for adults: ask for a two-year phased in program to provide Medicaid for adults under 100% of FPL.
   2. Expand the SCI program to extend coverage to adults up to 300% of FPL.
   3. Analyze the benefits and cost of various models for providing coverage for all New Mexicans using a stakeholder committee.

Task 1.2: Provide New Mexicans more opportunities for health insurance.

1. Increase medical support orders to increase the number of children receiving insurance through non-custodial parents' employer sponsored insurance.
2. Implement the Premium Assistance Program for non-Medicaid eligible children August 1, 2006 and pregnant women in the summer of 2006 utilizing funding approved for FY 07. Develop and implement program rules, eligibility, enrollment and payment processes as well as required information technology system changes.
3. Link low-income babies to services for a healthystart by increasing insurance for low income pregnant women.
4. Increase Medicaid enrollment of children by increasing outreach statewide, especially through schools, childcare and pre-kindergarten programs.
   1. Participate in events across the state including health fairs, tribal events and chapter house visits, college campus visits,and community fairs.
   2. Plan a "back to school" outreach effort to reach children as they register for school during August 2006.
5. Implement rule changes for children 0-5 and pregnant women, during summer 2006, increasing income disregards so that more children and women are eligible for Medicaid.
6. Implement rule change and/or amend state Medicaid plan to provide Chafee Medicaid to youth emancipating from foster care until age 21 with FY 07 funding.
7. In partnership with Navajo Area Director's Office, establish eight HSD workers at Shiprock, Gallup, and Crownpoint Indian Health Service (IHS) sites in July 2006 to determine eligibility on-site for Medicaid and Food Stamps.
8. Continue discussions with Albuquerque Area IHS to identify need for on-site eligibility workers within its service area, including sites in urban areas, and on Tribal and Pueblo reservations. Work with IHS and its service units to negotiate an arrangement for staffing these areas, which may include IHS funding a portion of workers' salaries and providing office space.
9. Increase number of adults enrolled in SCI and SEIP through outreach and marketing campaigns to employer groupsand self-employed individuals statewide, especially in rural areas and to Hispanic and Native American adults.