CHAMBER ASKS BERNALILLO COUNTY COMMISSION
TO REJECT IRB WAGE BILL
On Tuesday, the Bernalillo County Commission is scheduled to consider a resolution in support of House Bill 6, which would impose prevailing wages on Industrial Revenue Bond projects, raising the cost of IRBs and potentially diverting developer interests to other states. Here’s the letter sent by Del Esparza, Chairman of the Board, and Terri Cole, President and CEO, of the Greater Albuquerque Chamber of Commerce:
MEDICAID FOR EVERYONE? HERE COMES A POTENTIAL STATE BUDGET-BUSTER
The House Health and Human Services Committee gave a thumbs up today to House Bill 186 that would virtually allow every New Mexican to enroll in Medicaid (not Medicare) health insurance. The vote was 6-3, D’s in favor, R’s opposed. The bill now moves to the House Appropriations and Finance Committee.
Terri Cole, President and CEO of the Greater Albuquerque Chamber of Commerce, testified in opposition:
“We all know that the biggest share of the general fund goes to public education – nearly half. But, have we focused on the fact the second-largest piece of the budget is the current Medicaid program? It’s grown astronomically, largely due to Medicaid expansion – from $5.6 billion in fiscal year ’17 to $12.3 billion projected in fiscal year ’26. And, now we want to extend Medicaid to virtually everyone? That promises to be the budget-buster of all time.
“First, we really have no idea about how the program will be structured and what the premium payments will be, so it’s hard to get a handle on the actual budget impact. Second, the current mood in Congress is to reduce Medicaid support from the federal government, not increase it. So we can’t necessarily count on the largess of the federal Treasury.
“Finally, Medicaid Forward could do irreparable harm to the private insurance market. Why should we care about that? Because private insurance reimburses health practitioners and hospitals at higher rates – which is key in attracting practitioners and investments in hospitals. The Legislature has been struggling to increase Medicaid reimbursement rates – a big factor in increasing budget costs – we shouldn’t be discouraging private insurance. In fact, we should be doing the opposite in order to lessen the strain on the budget. Union-negotiated health care and other employer-provided plans could be in jeopardy if the private insurance market evaporates. HB 186 is a giant leap into budget uncertainty that could undermine the state’s fiscal health. We urge a ‘no’ vote.”
The Medicaid Forward Plan, as it’s known, is designed to charge premiums on a sliding scale based on income, with premiums being capped at 5% of household income. So, what happens if the premiums don’t cover the cost of care? What happens if the federal government significantly cuts Medicaid funding after New Mexico has gone down this path? Either the general fund will have to bail out the deficit or some kind of payroll tax will have to be imposed on employers. It’s a potential budget-buster for sure.
Also, opening Medicaid to everyone likely spells doom for the New Mexico Be Well Program (our version of Obama Care or the Affordable Care Act). A study performed for the Legislature suggests that 56,000 out of 70,000 Be Well participants will move to Medicaid Forward, likely resulting in unaffordable premiums for Be Well participants and leading to the implosion of this program.
This is why America’s Health Insurance Plans Association, Blue Cross/Blue Shield, the New Mexico Chamber of Commerce and the New Mexico Cancer Center also stood in opposition. Supporters argue that 10 years after Obamacare, there are still 200,000 people uninsured and it’s a matter of affordability. Sure, we all want to see families have access to quality medical care. But the cure here seems worse than the disease. If the heart of the problem is the 200,000 uninsured, then why not increase financial support to make the Be Well program more affordable? This would be targeted and much less likely to become a budget buster. Also, it’s likely that there are a significant number of people that won’t accept insurance no matter what.
We also note that if this measure were to become law, Medicaid recipients would be getting better benefits than Medicare recipients, even though Medicare recipients paid into the Medicare fund all their working lives. This seems very inequitable. And, Medicaid wasn’t designed to be, nor should it be stretched to be, health care for all. It’s a program designed to cover low-income families. This is why it is very questionable whether the federal government, especially with the current attitude toward spending, would grant a waiver to New Mexico. There’s simply too many rocks beneath the water to make for safe sailing.
WHEN YOU WISH UPON A BILL, THEN DO ALL OF YOUR DREAMS COME TRUE?
If House Bill 138, which seeks to mandate nurse and other health care professional staffing ratios in hospitals, passes into law, we’re about to find out. The House Health and Human Services Committee gave Rep. Kathleen Cates’ (D-Bernalillo) bill a do-pass on a 6-3 partisan vote, D’s in favor, R’s opposed. The measure now moves to the House Judiciary Committee.
We’re all in sympathy with how hard our bedside nurses have to work due to staffing shortages. According to the Fiscal Impact Report, however, the state faces a huge nursing shortage. Chamber President and CEO Terri Cole’s testimony nails the problem on its head:
“The Chamber stands opposed to HB 138. There’s an old Scottish proverb dating from the 1600s that says if wishes were horses, then beggars would ride. HB 138, in our opinion, has a lot of wishes that we all wish could come true – more skilled health care professionals. But trying to mandate hospitals to hire that which doesn’t exist won’t get us there.
“As the FIR points out, ‘an additional 5,353 registered nurses would be needed for all New Mexico counties to meet the national benchmark.’ That’s a gigantic gap to be closed. Getting there involves building the workforce pipeline that can improve staffing ratios. The Legislature in many ways is on the right track – increasing Medicaid provider reimbursement rates, providing tax and educational loan incentives, and joining compacts to attract professionals to our state are examples, and the Chamber continues to support these actions. A punitive approach of government mandates isn’t the solution. We need positive, proactive steps to build the workforce and to retain the professionals we have here now. We urge a ‘no’ vote on HB 138.”
Joining in opposition were several representatives of health care providers and hospitals. They pointed out that the unintended consequences of passage of this bill is actually less, not more, hospital beds available. Why? With the staffing shortages, the only way to meet staffing ratios is to limit the number of admissions and, therefore, the number of beds available. As the representative of a Las Cruces hospital pointed out, this forces sending patients to El Paso, Tucson or Albuquerque, separating them from their families. What’s needed is flexibility and building up the workforce pipeline, not imposing inflexible and unrealistic requirements.
In support of the measure were nurses and labor unions. The stories told by nurses are truly heart-rendering. We sympathize deeply with them. We just believe the better path is other approaches identified in Terri’s testimony. We, too, want to improve patient care and safety, along with those of our providers. This bill just doesn’t help get us there.
MISGUIDED NURSE-PATIENT RATIOS ROLLED
The final bill the Chamber followed in House Judiciary this afternoon was House Bill 72, sponsored by Reps. Eleanor Chávez and Elizabeth “Liz” Thomson (both D-Bernalillo), Rep. Joanne J. Ferrary (D-Doña Ana) and Majority Floor Leader Rep. Reena Szczepanski (D-Santa Fe) and Sen. Katy M. Duhigg (D-Bernalillo). D’Val Westphal, executive vice president of policy and programs with the Greater Albuquerque Chamber of Commerce, testified in strong opposition, telling the committee:
“While the Chamber appreciates the goals behind HB 72, striving to prevent nurse burnout and deliver higher quality care, the reality in our state, as in states throughout the nation, is a severe nursing shortage. According to testimony we’ve heard this session, thousands are needed. And the number one consequence of this legislation will be less care for more New Mexicans.
“What is a hospital to do when there are more patients than nurses in the ratio prescribed in HB 72? Turn them away? That’s not allowed in emergency cases. Our hospitals should not have predetermined cut-offs for how many patients can be served. And expecting hospitals to be able to quickly hire more nurses – or any medical professionals – is not realistic. It’s why we are seeing numerous bills this session, bills the Chamber supports, to join multi-state compacts so we can shore up our provider ranks.
“HB 72 also adds a new responsibility onto the Health Care Authority that is better managed at the hospital level. Our hospital directors of nursing are much better equipped to determine appropriate staffing for any given unit or facility as they know firsthand the many variables that go into providing nursing care: patient complexity and needs; the experience, education, qualifications, skills and competency of available staff; shift-to-shift variables; and patient turnover.
“For New Mexico’s patients, mandating staffing ratios when you are facing a staffing crisis is the wrong move at the exactly wrong time. And turning staffing decisions over to someone miles away, or embracing a one-size-fits-all approach, disregards the complexity of these decisions.
“We respectfully ask you to vote against HB 72.”
Also testifying in opposition were the New Mexico Hospital Association, University of New Mexico Hospital’s chief nursing officer, Encompass Health Rehabilitation Hospital in Albuquerque and Three Crosses Regional Hospital in Las Cruces. They cited the nursing shortage and the lack of flexibility the bill provides for those working in New Mexico’s hospitals.
Those in support – nurses, an attorney who represents injured patients, a medical student and patients – said the bill would make nursing in New Mexico a more attractive career, thus increases the number in the profession, and increase safety for patients.
HB 72 was amended to clarify nurses will be on the committee that determines staffing and that each hospital will submit an annual report to the nursing advisory committee.
After committee debate, the bill was rolled to allow the sponsors to sort out issues.
We’ll let you know if and when HB 72 returns.
HOSPITAL ACQUISITION – CURSE OR BLESSING?
Senate Bill 14, sponsored by Sen. Katie Duhigg (D-Bernalillo), seeks to require certain hospital acquisitions to receive regulatory approval from the Office of the Superintendent of Insurance (OSI) before the transaction can proceed. OSI can disapprove of a potential acquisition. There is a committee substitute that will potentially narrow the scope of the bill. Consequently, the bill was rolled over until Wednesday to give the committee and the public time to review the substitute.
J. D. Bullington testified in opposition to the measure on behalf of the Chamber:
“We are opposed to SB 14 because we’re concerned that the bill will have exactly the opposite effect as intended. Why do we say that? Our hospitals, especially our rural hospitals, are often cash-starved because of the high percentage of patients not covered by private insurance. The only solution to their problems may be acquisition by an entity that can bring cash to the table. It’s that or potential bankruptcy.
“SB 14 could potentially block or delay acquisitions that bring solutions, not problems. Our rural hospitals are the backbone of health care delivery in our smaller communities. We can’t afford to put them at financial risk. We need them to be financially healthy in order to compete for medical professionals. We understand that SB 14 seeks to help, not hurt. Unfortunately, we don’t see that as the case and respectfully ask you to vote ‘no.’ “
Also expressing opposition were the New Mexico Chamber of Commerce, Presbyterian HealthCare System, New Mexico Hospital Association, New Mexico Medical Society, the Greater Albuquerque Medical Association and Nurse Practitioners and the New Mexico Association for Home and Hospice Care. The New Mexico Chamber observed that the OSI is not the proper agency to regulate as they lack expertise in antitrust law but rather an independent agency with the right composition and expertise should be created instead. Presbyterian pointed out there are no guardrails on excessive regulation or for excessive regulatory delays. The Hospital Association voiced considerable concern over protection of confidential and trade-secret information. There generally is confusion about who’s regulated and who’s not.
Proponents, including the ACLU and trial lawyers, assert that New Mexico has one of the highest rates of private equity acquisitions, which they say reduces patient care and raises costs. In short, they believe that profits are placed over patient care, noting that the acquisitions are changing the face of healthcare delivery, resulting in its “corporatization.” There’s a lot to sort out in this complicated proposal. We’ll look forward to diving into the committee substitute and will give you an update following Wednesday’s hearing.
WATER QUALITY BILLS BACK ON WEDNESDAY
The Senate Judiciary Committee delayed action on two far-reaching water quality regulatory bills until Wednesday, given that both Senate Bill 21 and Senate Bill 22, sponsored by Senate Majority Leader Peter Wirth (D-Santa Fe) have committee substitutes to be considered.
The Chamber has been opposed to both, but we have yet to see and review the substitutes. SB 21 seeks to take over surface water regulation from the federal EPA because of a 2022 Supreme Court decision that restricts the waters of the United States that the EPA can control. SB 22 seeks to impose many new rules and regulations on regulation of water reuse, surface water permits and permit enforcement.
The economic effect on our oil and gas industry could be significant. We’ll dive into the committee substitutes and be ready to testify on Wednesday. Of course, we’ll keep you posted.
BILLS MIGHT BE HEADED TO CRIME PACKAGE
This afternoon, the House Judiciary took up two essential reforms in New Mexico’s public safety laws. After public comment and committee discussion on each, votes were not taken on either bill; instead, Chairwoman Christine Chander (D-Los Alamos, Sandoval & Santa Fe) said HB 16 would likely be included in the omnibus crime package, and it’s uncertain if HB 106 will be included in the crime package. Time will tell on that one.
PENALTY ENHANCEMENTS TO FENTANYL TRAFFICKING
The Chamber was in House Judiciary to testify once again in strong support of House Bill 16, Increasing Fentanyl Trafficking Penalties, sponsored by Reps. Charlotte Little and Cynthia Borrego, both (D-Bernalillo).
Little opened the discussion by saying, “every day is Survivors’ Day for families of opioid overdoses.”
D’Val Westphal, executive vice president of policy and programs with the Greater Albuquerque Chamber of Commerce, told committee members:
“It’s no secret that fentanyl is a major threat to the lives of New Mexicans. The good news is that, according to the New Mexico Department of Health’s recent report, overdose deaths have declined slightly from the peak of 1,029 in 2021 to 948 in 2023, the latest data available.
“The bad news is that’s still almost 1,000 people. Mexican cartels are importing and peddling this dangerous drug nationwide. It often comes in the form of fake pills, laced with other dangerous drugs. We must do everything we can to stop the drug trade and punish those that are literally purveying death. HB 16 establishes enhanced penalties for those trafficking, not consuming, large quantities of fentanyl – from 3 to 5 years depending on the amount after findings of fact by a jury or a judge.
“This bill is targeted at those trafficking the drug, not the victims. That’s exactly the right approach. We urge a yes vote on HB 16.”
Speaking up in support of the bill were New Mexico State Police Chief Troy Weisler, who said he has seen the same traffickers arrested over and over again with no consequences; Carla Sonntag of Better Together New Mexico, who expressed grave concern over fentanyl use and deaths by people not even intending to use the drug and said the state needs to take a stand against it. And Stephen Sisneros, who lost his brother in 2014 to a fentanyl overdose and said the state should look and lowering the amounts in the bill because just “two milligrams is considered a deadly dose by the DEA.”
As written, the bill targets true dealers, not someone giving a pill to a friend or addicts selling a few to feed their own habit – you must have 100–500 pills for the three-year enhancement, or more than 500 pills for the five-year enhancement. Little and her expert witness also pointed out these are not mandatory sentences but enhancements that can be added on to a sentence.
The lone opposing voice in public comment came from the ACLU of New Mexico, which voiced concern the bill embraces a tough-on-crime policy that doesn’t work and will lead to prison overcrowding and recidivism.
Speaker Javier Martinez, an attorney, said HB 106 “really goes to the heart of the problem,” that this is a “terrible industry, and it is pretty scary,” and while the legislation “is not perfect … it’s certainly an important step in the right direction.”
Chandler announced HB 16 will be rolled over for consideration into House Bill 8, which will be the vehicle for the omnibus crime bill and could be heard in House Judiciary on Wednesday.
BLOOD TESTS FOR ALL SUSPECTED IMPAIRED DRIVERS
The second crime bill up for consideration in House Judiciary today was House Bill 106, DWI Blood Testing, sponsored by career prosecutor Rep. Andrea Reeb (R- Chaves, Curry & Roosevelt). It was amended last week to remove references to cannabis amid concerns the testing for intoxicated driving regarding that drug isn’t quite ready for prime time.
The Chamber supported HB 106 in its first iteration and its second. The Chamber’s EVP D’Val Westphal testified:
“We greatly appreciate the sponsor’s hard work in listening to all those who support and have concerns about this bill, and we commend her for crafting a compromise that gives law enforcement and prosecutors the tool they need to better target drugged driving in our state.
“Whether it’s beer, hard liquor, a prescription drug or illegal narcotic, these substances can impair the safe operation of a vehicle and lead to injury or death, and all should be treated as such. Providing the ability for a blood test after a valid arrest for controlled substances like methamphetamine, cocaine, opioids, fentanyl – all the harder drugs for which there is reliable testing – will help law enforcement and prosecutors make our streets safer.
“Currently drivers can refuse a blood test if there has not been an accident causing great bodily harm or death, or if they don’t have three prior DWI convictions. HB 106 will give officers the tools they need to deal with the various substances drivers could be under the influence of, and before drivers have had three bites at the apple.
“The primary standard for any DWI conviction in New Mexico is when the defendant is proven “impaired to the slightest degree.” And impaired is impaired, by it by beer, hard liquor, prescription drugs or illegal narcotics. A blood test is the best way to back up law enforcement’s observations of impairment. The Chamber respectfully asks you to vote ‘yes’ on HB 106.”
Joining the Chamber in support of HB 106 were New Mexico State Police Chief Troy Weisler, who said the state has a growing problem of DWI regarding drugs, and law enforcement needs the additional tool of a blood test to back up officer observations in order to get a conviction. He explained it is very difficult to get a conviction for drugged driving without it. The New Mexico District Attorney’s Association testified the organization has supported a version of HB 106 for 13 years, and it is much needed. And Better Together New Mexico said the state’s DWI laws are woefully out of date and the addition of drugs is necessary.
The sponsor and her expert witnesses shared that New Mexico is one of the few, if not the only, state that does not provide for a search warrant to get a blood test for misdemeanor DWI (the first three DWI charges an individual faces). They also laid out that officers are trained to differentiate between impaired driving and driving by someone who is elderly, tired, dealing with an injury or poor balance, etc., and that impairment is very clear.
The only opposition was voiced by the New Mexico Law Offices of the Public Defender, which said the current standard of a felony (a fourth DWI in New Mexico) is the appropriate time to get a warrant for an invasive blood test, and New Mexico should stick with that law.
Chander, who’s also an attorney, asked if the blood tests can be exculpatory and clear a driver, and Reeb and her expert witnesses answered with a resounding yes and that in such a case, the case is then dismissed. Chandler says in her view the bill simply provides the best evidence possible for all involved in a case.
As we said at the top of this article, time will tell if this bill gets included in the crime omnibus package or not. We’ll keep you posted!
ENERGY STORAGE BILL COULD BE OUT OF JUICE
The House Taxation and Revenue Committee heard House Bill 51 this morning, Energy Storage System Tax Credits, sponsored by Rep. Debra M. Sariñana (D-Bernalillo). Support for the bill on the committee was as dry as your cellphone battery at the end of the day. The biggest concern, expressed by several committee members, is that the tax credit benefited higher-income taxpayers and provided no relief for low-income earners with no tax liability. The tax credit is meant to incentivize individuals to make an investment in energy storage.
Enrique C. Knell was there to support the bill on behalf of the Chamber, saying it “creates a cost-effective bridge for New Mexicans to make the financial leap into new energy options, as well as in shoring up the resilience of the electric grid.”
The bill was unanimously tabled. We don’t expect to see it again. But never say never up here!
SMALL-BUSINESS SATURDAY MIGHT STICK AROUND
Legislators were much more receptive to House Bill 179, which would extend the Small Business Saturday GRT exemption to 2030, avoiding a 2025 sunset. Small Business Saturday is the Saturday following Thanksgiving.
Enrique C. Knell again communicated the Chamber’s position, saying:
“Our overall goal for this session is to make New Mexico more competitive. The Small Business Saturday deduction helps us make local businesses more competitive during one of the busiest shopping weekends of the entire year. The tax holiday on gross-receipts tax is an effective tool for supporting our local small businesses. Encouraging people to buy local helps keep money in our community, supports small businesses and creates jobs.”
Strong local businesses mean a stronger tax base overall for New Mexico. The exemption provides a nice little boost to small, locally owned companies, and we’re glad to see it extended. The bill, carried by Rep. Doreen Gallegos (D-Doña Ana), was tabled in the committee but is likely to be included in the larger tax package.
AROUND THE ROUNDHOUSE
Federal Medicaid Contributions
As Medicaid Forward is discussed, it’s important to consider the impact of potential reductions in federal matching funds. A relatively small percentage reduction is hundreds of millions of dollars – dollars that the state budget could have to absorb on an ongoing basis. This is why we’re concerned that the Medicaid Forward program could be a budget buster.
IN THE HOUSE
Rep. Randall T. Pettigrew (R-Lea) introduced House Memorial 19, which honors law enforcement and its members’ impact with the community. Representatives spoke about their personal experiences, often with great emotion, and why they support the memorial. He was joined by many from both sides of the aisle.
Representatives also marked New Mexico Public Charter School Day. New Mexico charter schools are coming up on their 25th anniversary. Speaker Javier Martínez (D-Bernalillo) spotlighted South Valley Academy because it’s a school in his district that graduates 98% of each class, with 90% going to college. Among the schools recognized today were:
- Public Academy for Performing Arts
- Sun Mountain Community School
- Thrive
- Tierra Encantada
- South Valley Academy
- Gordon Bernell Charter School.
Rep. Andrea Reeb (R- Chaves, Curry & Roosevelt) recognized the Southwest Cheese Plant as a cornerstone in the local economy. Reeb said Southwest Cheese Plant opened in 2006 and is key to dairy farmers in the state because it provides stable employment to thousands of New Mexicans.
SIGNING OFF FROM SANTA FE
Trying to fit the right pieces of the health care puzzle together is a complicated and delicate task. Everyone wants the same goal, but there’s a widespread difference of opinion on how best to get there. This saga is far from over. Likewise with public safety measures. We’re waiting anxiously for the omnibus crime package to emerge, apparently on Wednesday. And, just because we’re the helpful sort, there’s only three shopping days left until Valentine’s Day. Thanks for joining us today, and until tomorrow we wish you a superb evening.
