New Mexico is experiencing vast budget shortages stemming from a historically limited private sector economy and lower than expected oil and gas revenues. Rarely, if ever have the state coffers been sufficient to fully fund the programmatic needs for improved education, a stronger justice system and expanded but needed healthcare. Of the three largest budget demands, only one is both a true economic and social positive multiplier to the improved well-­‐being of the state’s individual residents and the overall state wide economy: Medicaid. New Mexico is in an envious position of being able to obtain $3 in Federal match for each $1 the State provides. Likewise, every single dollar cut from the Medicaid program results in a combined $4 dollars less being released into our communities for hospitals, caregivers, medicines, healthcare workers, behavioral health services and those who often time care for our most vulnerable populations: single parents, children, working poor, chronically ill, the aged or disabled.

As a past individual recipient of Medicaid; a provider of inpatient and outpatient services to Medicaid recipients; and as a former government regulator of New Mexico’s Medicaid program I have first hand experience about our program and the significant contributions it makes to our people. Soon enough, nearly a million New Mexicans or almost 50% of our people will be served by the safety net provided for our at-­‐risk individuals of our economically, physically disadvantaged or aged populations. Many will argue wrongfully the program is burdened with providing indigent care to undocumented workers and their families. Totally untrue, the program is representative of our children, our neighbors, our family members and even some of our fellow workers.

Measured against most metrics, our Medicaid program is a model of efficiency. No Medicaid program is perfect, but our model is reflective of a vibrant medical community which is competitive, innovative, and delivers the greatest bundle of healthcare services with an already underfunded program in relationship to the demand. If more dollars were made available, monies should be invested in expanding healthcare in our rural communities, increasing behavioral health funding, supporting more care for the developmentally disabled and insuring our long term care providers can continue to fulfill their mission. Cutting Medicaid funding to our already frail delivery system like hospitals means making access and affordability much harder for populations that need healthcare the most. As previously reported, healthcare makes up about one quarter of the northern New Mexico job market, making cuts to this sector is disastrous to our communities. There is not a Medicaid spending problem in New Mexico, there is a revenue shortfall problem in New Mexico.

Very few alternatives to harmful budget cuts have been considered thus far. Health care advocacy groups have suggested increasing taxes on tobacco and alcohol to bridge the gap; they have not, however, proposed a percentage of increase, or investigated how much of a dent that increase would make in the budget shortage. At this point, it is clear the gap won’t be closed without slashing major programs or finding an entirely new source of revenue. So where is the state to turn?

Enter the argument for the legalization of the social use of cannabis on a statewide level. Conservative estimates based on the social use of cannabis and increased sales taxes in neighboring states indicate that recurring revenues could be in the range of $75 to $ 100 million annually in new revenues. This number is likely a conservative estimate for multiple reasons, including the exceeded expectations already recognized in the states of Colorado, Oregon, Washington and Alaska where legalization has been well analyzed and triggering a ‘green rush’. Add this to proven savings in areas like law enforcement, incarcerations, reduced court loads that would happen as an outgrowth of legalization. The social use of cannabis becomes an incredibly viable option for dependable state revenues, and $100 million revenue could generate a Federal match of up to $300 million dollars if fully directed to Medicaid.

New Mexico is considering extensive budget cuts and changes in areas where its citizens need funding the most. Not considering a revenue source which could add $400 million to our economy and meets the criteria of good health is not fiscally or socially responsible. Since 1948, the World Health Organization has consistently defined health (not amended even one time) as: “Health is a state of complete physical, mental and social well-­‐being and not merely the absence of disease or infirmity”. Fortunately, in New Mexico we have made great strides in expanding medical cannabis to treat the physical and mental well-­‐being of our people, the time has come to also address the social well-­‐being of our people. We need to remove cannabis from the unregulated illegal market. Similar to alcohol and tobacco we should legalize, regulate and tax the adult social use of cannabis in New Mexico. Salud New Mexico, approve the social use of cannabis and adequately fund Medicaid.