Jessey knows the difference Medicaid has made to her growing family. During her pregnancies, the New Mexican mother of three was able to afford checkups, prenatal specialists and breastfeeding pumps — without insurance, she likely couldn’t have paid her medical costs. “No, I would have probably went to las curanderas,” she says, before translating: “It’s like a witch doctor.”

She is like many mothers in Mora County in northeastern New Mexico. Almost everybody here is Hispanic, and poor. Four-fifths of Mora County children are covered by Medicaid — the federal-state health insurance program for low-income, disabled residents and others — the second-highest rate for a rural county, according to a report from Georgetown University (only Jefferson Davis County in Mississippi is higher).

But Jessey is worried. This summer, the U.S. Senate came one vote shy of passing a Republican health care bill that would have shaved billions from Medicaid — it had the imprimatur of President Trump, who campaigned promising not to cut such programs. If passed, mothers like Mora County treasurer JoJo Olivas say they probably won’t be able to afford basic hospital trips. Such concerns are especially urgent in the Land of Enchantment, where …

72 percent of New Mexican births are covered by Medicaid, the highest rate for any state.

What’s more, almost half of all births nationally are covered by Medicaid, according to a Kaiser Family Foundation survey that compiled data from state Medicaid directors. The high enrollment is good and bad, experts say. It reflects New Mexico’s poverty — the unemployment rate is 6.3 percent, trailing only Alaska — and high proportion of at-risk populations, including Native Americans and Hispanics. Yet it also shows the state has effectively enrolled residents. That’s important, because children’s health has educational and workforce ramifications too, says Richard Ellenberg, chair of the state Democratic Party.

The problem is that any asshole in Congress, if they need money for a ridiculous reason, can dip into the pot from which Medicare gets its money.

Floyd E. Maes, Mora County resident

Many conservatives suggest cuts to Medicaid are necessary for long-term viability, although how deep depends on the source (the New Mexico GOP declined multiple requests for comment). However, Washington pols may be short-sighted when they put Medicaid in their crosshairs, suggests Joan Alker, executive director of the Georgetown University Center for Children and Families. “The per-person cost, when you compare apples to apples, is the lowest,” compared to Medicare or private health insurance, she says. The reason for Medicaid’s rising costs is increased enrollment, plus an overall growth in health care bills. To wring out savings, “we need Congress to take action on the real culprit here — like the cost of drugs,” Alker says.

But some folks in places like Mora are skeptical Medicaid will last. “The problem is that any asshole in Congress, if they need money for a ridiculous reason, can dip into the pot from which Medicare gets its money,” says Floyd E. Maes, griping from his armchair. The octogenarian is wearing his Coast Guard hat. It was during his service that he was exposed to asbestos; he now requires a breathing tube. Without his VA health care, and the Medicare and Medicaid he also qualifies for, he would be “probably starving,” he says grimly.

For Jessey, Medicaid wasn’t just a lifesaver — it kept her financially solvent, and helped her seek post-traumatic stress disorder treatment for herself and her son after a domestic violence incident, she says. On weekdays, the 29-year-old (who asked not to include her last name due to stigmas around poverty) commutes an hour south with her three kids to take classes for a criminal justice degree. “It opened the floodgates for us in terms of therapy and adult therapy for myself, which I had never done — and it changed my whole life,” the hopeful future lawyer says.

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Where Medicaid Cuts Could Hurt the Most – OZY