Education Local Government Notable News Public Comments and Testimony Top Issues

What RGF’s president told the APS School board about new COVID restrictions

As has been widely reported in the media, Albuquerque Public Schools on Wednesday, introduced a whole host of restrictions on various activities at their schools.

Here’s a list of the new rules:

  • Wearing properly fitted masks outdoors as well as indoors
  • Students facing one way in classrooms and the cafeteria
  • Keeping students in cohorts
  • No spectators at school events, including athletics, through Feb. 2
  • Prohibiting large group gatherings, including assemblies
  • Staggering transition times and recesses
  • Closing drinking fountains (though students can still fill water bottles)
  • Restricting locker use.

Needless to say, not only is the RGF not a fan of several of these measures (masking outdoors?) but at the VERY least we believe that the new APS Board should be making these policies, NOT the superintendent  or any unelected bureaucrat.

So, here are RGF president’s Paul Gessing’s comments:

I was very happy to see the changes made to the board in the last election and I hope you will act quickly to wrest control over the District away from the bureaucrats.


I am the parent of three children who, up until the end of the abbreviated 2019-2020 school year, attended Chaparral Elementary on Albuquerque’s west side. We pulled our children out of APS for the 2020-2021 “virtual” school year and home schooled them because we knew that they would receive a vastly inferior education. Numerous studies have proven us correct.


Now our three kids go to a charter school OR Catholic school because APS has been completely inept in managing COVID and balancing the learning and socialization needs of children with a virus that has minimal impacts on children and has for the past two years.


The new COVID protocols at APS, adopted (so far as I can tell) without a vote of the Board, are unfair, unnecessary, and unscientific. I urge the board to take a public vote to overturn them and I urge ALL board members to vote to do so. Furthermore, in addition to overturning the new, unnecessary protocols, I urge the NEW APS board to eliminate the unnecessary mask mandate on children in the classroom.


Education Notable News Public Comments and Testimony Top Issues

Comment on Critical Race Theory in MLG’s proposed social studies curriculum

Gov. Lujan Grisham’s Education Department just released its new social studies standards. You can find all 122 pages here. As described below the standards are rife with Critical Race Theory (CRT) themes and other questionable material that may not fit squarely within CRT (read more on what that means here).

Before getting into some of the specific problems with the proposed standards, PED is NOW accepting public comments and will do so until November 12, 2021 at 5 p.m. (MDT). There will be a public hearing  Friday, November 12 from 1 p.m. to 3 p.m. (MDT) at Mabry Hall in Santa Fe.

All written rule feedback should be submitted to:

  • Fax505-827-6520
  • Mail: Policy Division, Public Education Department, 300 Don Gaspar Ave., Santa Fe, NM 87501

Here is a rundown of SOME of the problems with the proposed standards:

  1. In Ethics, Cultural and Identity Studies there is a requirement that students assess how social policies and economic forces “offer privilege or systemic inequity in accessing social, political, and economic opportunity.” This is classic CRT theology.
  2. Throughout the entire social studies curriculum for K-8 grades, there is a continue focus on the differences, rather than the similarities, among various groups of people.  This, too, is classic CRT as the purpose is to divide people among various minority groups, which can quickly lead to victimhood.
  3. There are also numerous example where a teacher can impose the notion of “justice and fairness,”  unequal power relations, “past and current injustices”, although those terms are open to many interpretations.  These phrases are also classic CRT as it perpetrates the sense of inequity in our society along racial lines. and and
  4. Within High School U.S. History, a requirement that students “evaluate what an efficient, equitable, and just economic system would look like in the U.S.”  This is again classic CRT as it imposes the belief on students that our current capitalistic system must be eliminated in order to eliminate racism.
  5. Within High School U.S. History, students are required to create an action plan for a more just and equitable America for diverse groups of people including Native Americans and African Americans.  This is another CRT theology component in that America is automatically unjust and inequitable to various minority groups.
  6. Within High School U.S. History, students are required to examine the past, present, and future of gun violence in the U.S.  Of course, there are no standards provided to discuss the constitutional rights of gun owners, or that individuals, not an inanimate object, are responsible for gun violence in America or how gangs, drug cartels, etc. have resulted in greater gun violence in our society. No positives regarding gun usage by women or minority groups are put forth.
  7. In the 5th Grade, students are  required to describe how inequity in the U.S. laid the foundation for conflict that continues today.  Another classic example of CRT as it stresses racial disparity in terms of inequality.
  8. Within High school U.S. History, students must examine the short-and long-term effects of CIA involvement in Latin America. How about pairing this with a discussion of Communism and the negative impact it has had in Cuba and other Latin American nations.
  9. In the 7thGrade, students must compare the patterns of exploration, destruction and occupation of the Americas by the Spaniards.
  10. Within High School U.S. History, students must explore the movement against police brutality.

RGF will be formulating its own comments in a subsequent post, but you are encouraged to submit your own and highlight this.

Economy Notable News Public Comments and Testimony Top Issues

With record economic strength Rio Grande Foundation files comments in support of able-bodied w/o children SNAP work requirement (and you can too)

Please click here to file your own comments in support of the Trump Administration’s proposal to end the abuse of SNAP time limit waivers for able-bodied adults without children. The deadline is April 2nd. The Rio Grande Foundation’s comments (including a link to an important study from the Foundation for Government Accountability) follow:

The Rio Grande Foundation is a free market public policy research organization based in Albuquerque. It is a non-profit, 501c3 organization and non-partisan in nature.

New Mexico is a state that has traditionally struggled economically, but even at a time like now of near record-low unemployment nationally and a relatively healthy New Mexico economy with abundant job openings there are too many able-bodied adults without dependents (ABAWD’s) on the federal food stamps (SNAP) program.

According to the Foundation for Government Accountability, there are 27,244 ABAWD’s in New Mexico that are currently exempt from the SNAP work requirement. This is not a healthy situation for them and their self-worth, job skills, and ultimately their mental and physical health. The compassionate thing to do is for federal and state policies to push these people to get back in the work force.

This happens to be best for both the New Mexico and national economy as well where these productive, engaged members of society can be active participants in the economy and thus tax-paying citizens as opposed to recipients of welfare provided at taxpayer expense. More importantly, even in areas of relatively high unemployment the ABAWD time limit waiver slows state and national economic growth by decreasing the chance that New Mexicans receiving welfare benefits will search out the jobs that are being created as our state’s economy improves.

We strongly support the Administration’s efforts to end the abuse of SNAP time limit waivers and further call on them to prohibit waivers in any area that does not have unemployment above the 10 percent the statutory threshold and to end the unlimited carryover of ABAWD percentage exemptions in order to encourage broader application of the statutory ABAWD work requirement

These waivers are counterproductive policies that have the unintended effect of trapping SNAP participants in the cycle of dependency and poverty while stressing resources intended for the truly needy. They increase the likelihood that a participant and their family will remain on assistance, making them more likely to live in poverty.


Economy Notable News Public Comments and Testimony Tax and Budget Taxes Top Issues

Holtec could bring high-paying jobs, tax benefits

New Mexico’s elected leaders and many citizens often claim to be interested in “diversifying the economy” and attracting good-paying new jobs to our state. When push comes to shove, however, schizophrenia reigns.

Policymakers often outdo themselves throwing subsidies and tax exemptions at businesses while they enact policies or restrictions that make doing business in New Mexico unattractive.

As has been reported in the media, Holtec International has proposed the construction of an “intermediate” storage facility for spent nuclear fuel to be located between Carlsbad and Hobbs. The facility would create as many as 135 jobs, including the construction and operating workforce. Operating jobs would pay between $60,000 and $80,000 annually. The state would experience a total increase in income from direct jobs of about $7.9 million and approximately $820,000 in personal income tax and New Mexico Gross Receipts Tax. This facility represents a major investment in New Mexico’s economy.

This facility received overwhelming bipartisan support from both houses of the Legislature during the 2016 session when both houses passed memorials supporting the proposed Holtec facility.

Economically speaking, Holtec’s plan resembles the Facebook facility in Valencia County that has generated so many positive news stories and resulted in tens of millions of dollars in subsidies from state and local governments.

The biggest difference – aside from Holtec not having asked for subsidies – is the public’s sympathy toward Facebook and its antipathy toward nuclear storage. Holtec’s proposed facility is extremely safe. Safeguard upon safeguard will be implemented to ensure against accidents both in transit and at its final destination.

The issue of nuclear storage transcends New Mexico’s economy, but if it is approved and becomes operational, Holtec’s facility could go a long way toward resolving America’s near-term nuclear storage challenges.

Currently, spent nuclear fuel is stored on-site at nuclear power facilities across the nation. This situation is viewed as sub-optimal by supporters and detractors of nuclear power alike. One or more secure central storage facilities are needed to ensure the spent nuclear fuel is stored safely.

The long-term solution proposed by the federal government is the politically-challenged Yucca Mountain facility in Nevada, which has cost taxpayers billions of dollars and may never be used for its intended purpose. Holtec’s proposed facility provides at least a starting point for a solution that will save federal taxpayers a great deal of money due to fact that federal taxpayers have been paying tens of billions of dollars in fines to utilities in recent decades due to the federal government’s failure to come up with a nuclear storage solution.

And, while nuclear energy is unlikely to grow dramatically in the near-term due to the rise of inexpensive natural gas and increased energy efficiency of the U.S. economy, solving the nuclear storage problem would remove a major obstacle to the industry’s resurgence. As concerns about CO2 emissions and man-made climate change intensify, an increasing number of pro-nuclear environmentalists including, but not limited to, NASA scientist James Hansen and Greenpeace founder Patrick Moore may cause nuclear to gain market share once again.

All of this means that by resolving a certain important aspect of the nuclear storage problem, this Holtec facility could:

• Directly generate new, high-paying jobs and tax dollars for New Mexico;

• Help solve the United States’ nuclear storage woes, thus improving the odds for a zero-carbon energy source which in turn;

• Spurs future demand for uranium production, an industry which at one time served as the backbone of economically-depressed areas of west-central New Mexico.

On that last point, it is true that many communities have been negatively impacted by uranium mining in the past. Modern safety advancements and stricter regulations would mean that a nuclear resurgence could be an economic engine for multiple areas of the Land of Enchantment.

As the only state with two national laboratories specializing in nuclear research, New Mexico has always been on the cutting edge of nuclear technology. The proposed Holtec International storage facility is yet another opportunity for the state to lead the way with tremendous immediate economic benefits as well as longer-term potential for a return to growth of a clean and reliable form of zero-carbon emissions energy.

The Rio Grande Foundation is an independent, non-partisan, tax-exempt research and educational organization dedicated to promoting prosperity for New Mexico based on principles of limited government, economic freedom and individual responsibility.

Economy Energy and Environment Notable News Public Comments and Testimony Top Issues

Weighing in on NM’s Newest Nuclear Opportunity

Last week, Errors of Enchantment had some fun with the ignorance and fabuliusm exhibited by opponents of Holtec International’s proposal to build a facility for spent nuclear fuel (SNF) in southeast New Mexico.

This week, though, it was time to leave “the puppies of Chernobyl” behind, and get serious. The Rio Grande Foundation has submitted its comments on Holtec’s license application to the U.S. Nuclear Regulatory Commission (NRC). Our ten-page analysis lays out the case for the facility — not just its negligible risk to public safety and the environment, but the role it could play in fundamentally reforming the nation’s broken, and expensive, SNF architecture.

Our arguments include:

* Environment: Holtec is proposing to cite its facility in a remote, lightly populated, extremely dry, and seismically stable portion of the American Southwest. Wildlife in the region is scarce, and the three federally listed species in Lea County are unlikely to be adversely affected by a facility that, at full build-out, would encompass merely 330 acres — in a county that contains more than 2.8 million acres. Hurricanes and tornadoes are basically nonissues at the location, and CIS will have negligible impact on air quality. No historical buildings will be destroyed, and no significant cultural/archeological sites disturbed.

* Transportation Safety: Contrary to the popular image of nuclear “waste” as a green, gooey, dripping, glowing substance, SNF consists of rather ordinary-looking bundles of ceramic metal contained in long, thin tubes. Movement of SNF on America’s roads and rails has an essentially unblemished safety record. A 2007 analysis by The National Academy of Sciences found “no fundamental technical barriers to the safe transport of spent nuclear fuel and high-level radioactive waste in the United States. When conducted in strict adherence to existing regulations, such transport is a low radiological risk activity with manageable safety, health, and environmental consequences.” An essay written by 19 members of the National Academy of Engineering noted: “Extensive analysis, backed by full-scale field tests, show that there is virtually nothing one could do to [SNF] shipping casks that would cause a significant public hazard. Before shipment, the fuel elements have been cooled for several years, so the decay heat and the short-lived radioactivity have died down. They cannot explode, and there is no liquid radioactivity to leak out. They are nearly indestructible, having been tested against collisions, explosives, fire, and water.”

* Security: Terrorists strike heavily populated areas, using easily obtained or assembled weapons such as guns and bombs. They are unlikely to attempt to hijack or damage SNF headed for Holtec’s facility. And once the fuel assemblies arrive, they will not offer tempting targets. In addition to the deterrent of on-site, armed security and zero potential to inflict harm on a large number of victims, Holtec’s HISTORM UMAX system “stores the canister containing SNF entirely below-ground to serve as a ‘security-friendly’ storage facility, providing a clear, unobstructed view of the entire CIS Facility from any location and the closure lid is a massive steel weldment filled with concrete, virtually eliminating the storage contents as a target for malevolent acts.”

* Economic Development: Holtec’s total investment, across several decades, would be hundreds of millions — if not billions — of dollars. Including the construction and operating workforce, the facility could create as many as 135 jobs. The state would experience a total increase in income from direct employment of nearly $8 million, and over $800,000 in personal income tax and GRT revenue. New Mexico’s economy, suffering from low wages and one of the worst unemployment rates in the nation, desperately needs projects like Holtec’s proposed facility.

* Policy Reform: Perhaps the best justification for CIS in New Mexico is the contribution it could make to shifting away from the nation’s costly and spectacularly unsuccessful attempt to build and operate a SNF facility at Yucca Mountain in Nevada. The federal government has squandered over $20 billion in ratepayer and taxpayer funds on a one-size-fails-all approach. Supporters of atomic energy should concede that technocracy has failed. A new strategy, founded on the transformative power of property rights, competition, and private-sector accountability, promises a better path. New Mexico stands to benefit from a consent-based alternative that buys decades, if not centuries, to find workable SNF solutions.

The NRC has extended the public-comment period to July 30, and your thoughts can be “submitted through the federal government’s rulemaking website,, using Docket ID NRC-2018-0052.” Feel free to add your voice to the list of New Mexicans who consider Holtec’s proposal an opportunity to bring jobs and tax revenue to the Land of Enchantment — and along the way, finally terminate the billion-dollar Yucca Mountain boondoggle.

Economy Notable News Public Comments and Testimony Top Issues

RGF submits comments to USDA in support of restoring work requirement for able-bodied SNAP recipients

The Rio Grande Foundation has long supported restoration of work requirements for able-bodied food stamp recipients without children. Left-wing groups throughout the State have consistently opposed such efforts.


The Rio Grande Foundation submitted the following comments in support of restoring the work requirement.


Comments are due on April 9 and can be submitted here:

USDA should eliminate SNAP ABAWD time limit waivers altogether and require all able-bodied adults without children to work, train or volunteer in order to receive benefits.

These waivers are counterproductive policies that have the unintended effect of trapping SNAP participants in the cycle of dependency and poverty while stressing resources intended for the truly needy. They increase the likelihood that a participant and their family will remain on assistance, making them more likely to live in poverty.

Current policy uses state-level unemployment data to waive ABAWD work requirements, but this is a deceptive data point. For instance, New Mexico’s unemployment rate is 5.8 percent, substantively higher than the 4.1 percent national average. But only one county in our state is above the 10 percent threshold for county-level unemployment waivers, while residents of three counties where unemployment is under the national average are still exempt from work requirements.

More importantly, even in areas of relatively high unemployment the ABAWD time limit waiver slows state and national economic growth by decreasing the chance that New Mexicans receiving welfare benefits will search out the jobs that are being created as our state’s economy improves. This is the time for people to rejoin the workforce, as unemployment has dropped 0.6 percent in the past 12 months. Notably, in a state with an estimated 53,900 unemployed workers,[1] there are almost 10,000 “entry-level” jobs posted on just one Internet job board.[2] Restoring the incentive to find work will move more New Mexicans off assistance and into those open jobs, further growing the economy while reducing the burden to taxpayers.

The Trump Administration should be praised for taking on the disastrous policies of the last decade that quintupled the number of able-bodied adults without children receiving SNAP benefits nationwide. To reverse this unsustainable trend, USDA’s efforts to help SNAP participants find and maintain meaningful unemployment would be best served by implementing the principle that able-bodied adults without children must be required to work, train or volunteer in order to receive benefits.




Constitution and Criminal Justice Notable News Public Comments and Testimony Top Issues

Rio Grande Foundation President Paul Gessing Provides Updated Comments on SoS Revised “Disclosure” Regulations

Albuquerque, NM – In response to revised regulations being proposed by New Mexico Secretary of State Maggie Toulouse-Oliver, the Rio Grande Foundation has revised its previously-submitted comments.

Said Rio Grande Foundation president Paul Gessing in the Foundation’s revised comments, “We applaud the Secretary of State for narrowing the scope of the proposed rules. Nonetheless, the Rio Grande Foundation remains concerned about the rules as written and the vague and complicated language and requirements they contain.”

Gessing noted that his primary concern with the proposed regulations remains procedural. Legislation addressing donor disclosure was vetoed by Gov. Martinez in the wake of the 2017 legislative session. These regulations are rightly the purview of New Mexico’s Legislature and Executive, not the Secretary of State.

In terms of our concerns regarding the proposed rule itself, the Foundation expressed a desire for clarification as to whether the Rio Grande Foundation and similar 501c3s would not be covered by the rule. In particular, we recommend that you consider revising the rulemaking again by amending the “advertisement” definition to explicitly exempt 501c3 organizations engaging in grassroots lobbying. If this change was made, it would remedy the Foundation’s chief concern about the rulemaking.

While some of the new language represents an improvement over the previously-proposed disclosure rules, we do have some serious concerns regarding the newly-added language in the “Coordinated Expenditures” section of the revised rulemaking.

Public testimony on the revised proposal will be accepted on August 30 in Santa Fe. Details including how to file your own comments can be found here.

You can read the full written comments here.

A video illustrating the importance for donor privacy can be found below:

Notable News Public Comments and Testimony Top Issues

A secretary of state power grab on nonprofit privacy

The following appeared in the Santa Fe New Mexican on July 12, 2017.

We all know how a bill becomes a law, right? A lawmaker writes a bill, the Legislature passes it, and then the governor signs it. At least, that’s what the New Mexico Constitution says. Unfortunately, losers in the legislative process are increasingly willing to ignore that process, and a rule-making currently underway in Santa Fe shows how.

This spring, the New Mexico Legislature considered imposing new donor disclosure rules on nonprofit organizations. The measure was vetoed by Gov. Susana Martinez over privacy concerns. Now Secretary of State Maggie Toulouse Oliver is attempting to impose those rules by bureaucratic fiat, using a regulation to enact what couldn’t be done through the normal lawmaking process.

Bureaucratic rule-makings can serve an important function. They help to implement and clarify laws that are passed by the Legislature. But here, instead of implementing the law, the Secretary of State’s Office is enacting rules that were rejected in the constitutional lawmaking process. Although pitched as “political disclosure,” as Martinez wrote in her veto message in April, “the broad language in the bill could lead to unintended consequences that would force groups like charities to disclose the names and addresses of their contributors in certain circumstances.”

Furthermore, the rules, if adopted, will almost certainly be challenged in court. It wouldn’t be the first time New Mexico got itself in hot water by adopting “broad language” to try to “improve” political transparency. In New Mexico Youth Organized, et al v. Herrera, the 10th Circuit Court of Appeals held that New Mexico’s definition of “political committee” was unconstitutional. The case concerned two progressive nonprofits that had spent a small portion of their budgets criticizing candidates for ties to health insurance interests.

Nevertheless, the Secretary of State’s Office now wishes to regulate this type of private activity. Forcing nonprofits to comply with rules akin to those for political committees conflicts with the 10th Circuit’s clear guidance that political action committees may “only encompass organizations that are under the control of a candidate or the major purpose of which is the nomination or election of a candidate.” If the defeated bill is enacted as a regulation, citizens will likely see their tax dollars spent defending a rule already rejected in the legislative process.

Even if the state were to prevail in court this time around, these nonprofit disclosure rules would not improve politics in New Mexico. If every citizen group that speaks about candidates’ policy positions and voting records has to behave like a PAC, pretty soon only PACs will have a voice in elections. Grass-roots and volunteer-run groups like New Mexico Youth Organized won’t be able to afford the attorneys necessary to comply with complex reporting rules. How does that help the average New Mexican voter?

Nonprofit speech about candidates allows voters to hear the varied perspectives of groups that do valuable work in our communities. For a variety of religious, civic and political reasons, many donors to these organizations do not want to have their names and home addresses published online for their boss and nosy neighbors to see. Rest assured, many groups will choose silence over exposing their supporters’ private information.

Political transparency and personal privacy don’t have to contradict. Political committees can be made to disclose their donors without inhibiting everyone else from speaking. Donors who earmark their nonprofit gifts for campaign-related speech can be reported to the government without violating everyone else’s privacy.

The secretary of state’s proposed rules, however, would sweep up charities and their supporters as well. This isn’t just political speech. Just mention a candidate by name near any election and you’re at risk under the secretary’s proposed regulation. Martinez wisely chose to avoid this course of action for New Mexico. We should be cautious when considering proposals that restrict or chill charitable giving. We should especially not impose such policies through a subversion of the democratic process.

If this matter were appropriate to be handled by the secretary of state, it would never have been submitted to the Legislature and governor. The secretary’s proposed rules are both bad in substance and an abuse of her rule-making authority.

Bradley A. Smith, who served on the Federal Election Commission from 2000 to 2005, is chairman and founder of the Center for Competitive Politics, the nation’s largest organization dedicated solely to protecting First Amendment political rights. Paul Gessing is president of the Rio Grande Foundation, an independent, nonpartisan, tax-exempt research and educational organization dedicated to promoting liberty, opportunity and prosperity for New Mexico.

Constitution and Criminal Justice Notable News Public Comments and Testimony Top Issues

Rio Grande Foundation President Paul Gessing Comments on SoS “Disclosure” Proposal Regulations

Albuquerque, NM – The Rio Grande Foundation has submitted comments to New Mexico Secretary of State Maggie Toulouse Oliver in opposition to proposed new regulations aimed at forcing charitable non-profits – like the 501(C)(3) – Rio Grande Foundation to disclose its donors if the organization attempts to educate voters about public policy issues.

For example, any discussion of a candidate, even an incumbent officeholder who is running the government, can trigger the “independent expenditure” requirements if it is done close in time to an election. Thus all 501(c)(3) organizations are under threat of having to disclose their donors, even if they are only focusing on issues, if they happen to mention a candidate (and candidates are often incumbent officeholders).

Fresh from its efforts to educate voters in Santa Fe on the impact of sugary drink taxes, the Rio Grande Foundation understands all too well how well-intentioned disclosure regulations can hinder citizen involvement in the political process both through the disclosure process itself as well as due to onerous paperwork burdens placed upon citizens.

Foundation president Paul Gessing will be present to deliver public testimony at comment periods in both Santa Fe and Albuquerque.

You can read the full written comments here.

Public Comments and Testimony

Paul Gessing’s Testimony on the economic impacts of Medicaid expansion: Before the Health and Human Services Committee New Mexico Legislature, Santa Fe

Good morning Sen. Ortiz y Pino, Rep. Espinoza, and members of the committee. I am Paul Gessing, president of the Rio Grande Foundation, an independent, nonpartisan, tax-exempt research and educational organization dedicated to promoting prosperity for New Mexico.

I appreciate this opportunity to provide my organization’s perspective on whether the benefits of Medicaid expansion in New Mexico outweigh the costs and whether a “multiplier effect” exists by which increased federal dollars will generate increased economic growth in our state.


Before discussing the economic and multiplier impacts of Medicaid expansion, I feel it is important to discuss the impact of Medicaid on actual health care outcomes. Supporters of free markets and skeptics of the efficacy of government programs are are often accused of being callous or uncaring to the poor, but we actually want government spending to be used in ways that have proven, positive results.

There is no question that Medicaid expansion is a massive expansion of a health care entitlement. According to Congressional Budget Office, between 2014 and 2022, expanding Medicaid will cost American taxpayers at the combined federal and state levels $1 trillion. Before discussing the economic impact on New Mexico, it is important to ask what kind of health care we getting for that money.

For starters, the inspector general of the Department of Health and Human Services found that over half of providers no longer accept Medicaid patients. Of doctors who do accept Medicaid, the provider networks are narrow and nearly one-third face wait times of over a month.

Last year, The Wall Street Journal profiled Farmington family physician Holly Abernethy, who

has turned away all newly eligible Medicaid beneficiaries because she can’t sustain her practice expenses if her proportion of Medicaid patients grows much beyond her current 13%.

For a moderately complex office visit, she is paid about the same as [a] nurse practitioner: about $80 from Medicaid and about $160 on average from commercial insurance.

Says Dr. Abernethy, “I would love to see every Medicaid patient that comes through my door.” “If you give people coverage, they should be able to utilize it.” But making it work would extend her workday, and “I have three small children and I miss them.”

Moving from anecdotal to empirical evidence, it is worth considering Oregon’s experience. In 2008, a total of 29,835 Oregonians were given the opportunity to apply for the state’s Medicaid program out of almost 90,000 people on the waitlist. About 30 percent of those who were selected from the waitlist both chose to apply for Medicaid and met the eligibility criteria. Because it examined a unique, real-world experiment complete with a randomly selected control group, the study of Oregon’s Medicaid expansion is considered the “gold standard” in health-care research.

The study’s results have been published in academic journals, including The New England Journal of Medicine and the The American Economic Review in 2013. Its conclusion was that “Medicaid increased health care utilization, reduced financial strain, and reduced depression, but produced no statistically significant effects on physical health or labor market outcomes.”

The Oregon study is not alone in casting a skeptical light on Medicaid’s health benefits:

• A 2010 study of 1,231 patients with cancer of the throat, published in the medical journal Cancer, found that Medicaid patients and people lacking any health insurance were both 50 percent more likely to die when compared with privately insured patients—even after adjusting for factors that influence cancer outcomes. Medicaid patients were 80 percent more likely than those with private insurance to have tumors that spread to at least one lymph node.

• A 2010 study of 893,658 major surgical operations performed between 2003 to 2007 published in the Annals of Surgery found that being on Medicaid was associated with the longest length of stay, the most total hospital costs, and the highest risk of death. Medicaid patients were almost twice as likely to die in the hospital than those with private insurance. By comparison, uninsured patients were about 25 percent less likely than those with Medicaid to have an “in-hospital death.”

• A 2011 study of 13,573 patients, published in the American Journal of Cardiology, found that people with Medicaid who underwent coronary angioplasty (a procedure to open clogged heart arteries) were 59 percent more likely to have “major adverse cardiac events,” such as strokes and heart attacks, compared with privately insured patients. Medicaid patients were also more than twice as likely to have a major, subsequent heart attack after angioplasty as were patients who didn’t have any health insurance at all.

• A 2011 study of 11,385 patients undergoing lung transplants for pulmonary diseases, published in the Journal of Heart and Lung Transplantation, found that Medicaid patients were 8.1 percent less likely to survive 10 years after the surgery than their privately insured and uninsured counterparts. Medicaid insurance status was a significant, independent predictor of death after three years—even after controlling for other clinical factors that could increase someone’s risk of poor outcomes.

In all of these studies, the researchers controlled for the socioeconomic and cultural factors that can negatively influence the health of poorer patients on Medicaid.

So why do Medicaid patients fare so badly? Payments to providers have been reduced to literally pennies on each dollar of customary charges because of sequential rounds of indiscriminate rate cuts. As a result, doctors often cap how many Medicaid patients they’ll see in their practices. Meanwhile, patients can’t get timely access to routine and specialized medical care.

All that being said about the most important issue, the impact of Medicaid on health outcomes, I am primarily here to discuss the financial impact of Medicaid expansion on New Mexico’s economy and state budget.

In the current fiscal year, New Mexico will spend more than $5.5 billion on Medicaid, with state revenue covering just under $900 million of the total. By 2017, fully a third of the state’s population will be on Medicaid. At a time when revenue is dropping from the decline of the oil-and-gas sector, the program is seriously jeopardizing the state’s ability to balance its budget. By 2020, it is estimated that the state’s bill for covering newly eligible Medicaid recipients will be $163 million.

A Flawed Theory

The “multiplier effect” is the theory that government spending stimulates jobs creation and income growth. Many proponents of Medicaid expansion claim that since it is largely funded with “free” money from Washington, it is an economic-development tool. But, as Harvard economist Robert Barro explained in a September 2009 National Bureau of Economic Research paper, “it is wrong … to think that added government spending is free.” The money Washington is sending to New Mexico for Medicaid must come from either taxes or borrowing.

The national debt is currently $18.6 trillion. At least in the short term, the burden is sure to grow. Unfunded liabilities for Social Security and Medicare are estimated to be in the hundreds of trillions of dollars. This level of debt-creation will not continue. New Mexico, a state uniquely dependent on Washington appropriations, cannot count on an endless spigot of federal cash, for Medicaid or any other program. A reckoning is coming. It is likely to be very ugly for taxpayers in the Land of Enchantment.

The ‘Medicaid Multiplier’ Exposed

On the issue of the multiplier itself, after conducting a survey of the economic literature, Valerie Ramey, an economist at the University of California, San Diego concluded: “For the most part, it appears that a rise in government spending does not stimulate private spending; most estimates suggest that it significantly lowers private spending.” Studies by many others, including economists at the International Monetary fund, concur with Ramey’s finding.

In an effort to better understand the alleged “multiplier effect,” the Rio Grande Foundation recently examined economic performance in the 24 states that expanded Medicaid in January 2014, comparing it with the 20 states that did not. Despite tens of billions of “free” money flowing into expansion states with no state match required until 2017, the percentage of job growth in the two groups was essentially the same, with a slight edge to the non-expanding states:

The absence of a Medicaid “multiplier” is particularly stark in New Mexico. Residents continue to leave our state, the labor participation rate is falling, and unemployment is rising. Our state has yet to recover the number of jobs it had during its employment peak, more than seven years ago. The state’s extensive matrix of welfare programs is surely an incentive to remain on public assistance rather than seek opportunities in the job market.

There are many weaknesses in the claim that Medicaid expansion creates jobs for the workers needed to treat newly eligible beneficiaries. While employment in New Mexico’s health-services industry is rising, it is not at all clear that Medicaid expansion is causing the growth. The sector has been adding jobs for many years, and even increased its employment during the Great Recession.

Even if it were the case that Medicaid expansion creates healthcare jobs, in the assessment of Harvard scholars Katherine Baicker and Amitabh Chandra,

(e)mployment in the health care sector should be neither a policy goal nor a metric of success. The key policy goals should be to achieve better health outcomes and increase overall economic productivity, so that we can all live healthier and wealthier lives. Our ability to ensure access to expensive but beneficial treatment is hampered whenever health care policy is evaluated on the basis of jobs. Treating the health care system like a (wildly inefficient) jobs program conflicts directly with the goal of ensuring that all Americans have access to care at an affordable price.

One penalty of Medicaid expansion that its proponents consistently avoid addressing is the impact it has on those with non-government coverage. Broadening the program imposes “a hidden tax on … people with private insurance. Expanding Medicaid leads hospitals and doctors to shift costs onto patients with private insurance thus making private insurance less affordable and contributing to the vicious cycle of increasing the number of people without insurance.” Prices for insurance premiums are rising—not falling, as Obamacare supporters claimed – and Medicaid expansion is a likely contributor to the cost of private coverage.

In Conclusion

Prior to the enactment of this new health care law, Medicaid provided New Mexico with 70 cents on the dollar with little evidence that it “stimulated” New Mexico’s economy.

Perhaps the worst aspect of Medicaid expansion is that, like so many federal programs, it relied on the promise of “free money” to the states. If any welfare program is worth enacting or expanding, it should be the taxpayers of New Mexico that support paying into a program for the benefit of their friends and neighbors. After all, we all do want better health care outcomes.

A cash-grab based on long-discredited Keynesian “stimulus” theory with little or no health benefits isn’t just unwise, it’s immoral. Think of what else we could do with $1 trillion.

In the short term, New Mexico should work with other states to press the federal government for the flexibility required to fix a badly broken and irresponsibly unsustainable program.

Medicaid desperately needs a sweeping overhaul. Reforms must be consumer-oriented, permitting beneficiaries to obtain private coverage in a competitive marketplace. Time limits similar to those imposed under the creation of the Temporary Assistance to Needy Families program in the 1990s, are also worth consideration.

In the long term, aggressive implementation of proven economic-development strategies will create the prosperity that will enable New Mexicans to obtain private insurance, either through their employers or purchased individually. The way to gauge successful healthcare policy in New Mexico is to track how many people are leaving, not joining, our population of Medicaid enrollees.

Thank you for your time today.