Now is the time to repair our health care shipwreck before it sinks us all.
By Mick Rich
Image: U.S. Navy via Wikimedia Commons, public domain
his article was first published in American Thinker (a daily online publication) on October 26, 2025
Democrats wrote the Affordable Care Act (Obamacare), passed it in Congress, and President Obama signed it into law. It was the first major legislation in decades to reshape a vast sector of the economy—healthcare—affecting every American, and it was enacted entirely by one party. No wonder the unintended consequences of Obamacare have been as far-reaching as the law itself. New Mexico, then as now, stands at the forefront of that battle.
On August 22, 2009, Congressman Martin Heinrich hosted a town hall with Dr. Michael Richards (then Chair of UNM's Department of Emergency Medicine), Dr. John Vigil (Medical Director, Doctors On Call Urgent Care), and Paul Gessing (President, Rio Grande Foundation). My oldest daughter—then an aspiring medical doctor, now a radiologist—and I—then an aspiring elected official—attended.
I expected Heinrich's panel to feature two physicians supporting Obamacare and one free-market advocate opposing it. To my surprise, all three panelists expressed some level of opposition. Heinrich's response was telling: regardless of their opinions, he would still support Obamacare.
As expected, Heinrich repeated the now-infamous promise: "If you like your doctor, you can keep your doctor." If you like your health plan, you can keep your health plan. And costs will go down as coverage expands.
Within two years, my primary care physician retired. He said healthcare had become more about paperwork and less about patients, while his pay decreased. Around the same time, my company's employee health plan was dropped. The replacement came with higher premiums and deductibles. Within five years, we could no longer afford to cover our employees' dependents.
It wasn't just small businesses that struggled. Rural hospitals in New Mexico did, too. Obamacare cut subsidies to these hospitals under the assumption that more insured patients would offset the losses. That didn't happen. By 2014, the Obama administration expanded Medicaid to plug the gap, and New Mexico eagerly accepted, adding 130,000 enrollees. Under President Biden, COVID-era subsidies swelled Medicaid rolls by another 146,000. By the end of his administration, nearly one million New Mexicans were on Medicaid.
This expansion came at a cost—borne by physicians and federal taxpayers. Medicaid and Medicare reimbursements are low but tolerable when they account for only a small share of a practice's revenue. In New Mexico, however, Medicaid and Medicare now cover 61% of the population. Another 9% remain uninsured, leaving only 30% of residents providing fair reimbursement—and effectively funding healthcare for the remaining 70%.
Our physicians can—and do—leave New Mexico for better pay elsewhere. And as other states tire of subsidizing ours, the system will collapse under its own weight.
Today, Democrats in Washington are once again holding the country hostage over healthcare. In 2009, Obama, Pelosi, and Reid pushed the ACA through alone. Since then, they've layered patch after patch to fix its unintended consequences. If Washington demands yet another payoff to keep the system afloat, the nation will face what New Mexico already is: a shortage of doctors and a shrinking base of taxpayers footing the bill.
Now is the time for Republicans and Democrats to come together—to repair our healthcare shipwreck before it sinks us all.
Mick Rich has had the opportunity to look behind the curtain of the Healthcare Industry. Mick Rich's wife is a pharmacist; one daughter is a former surgical physician assistant and is now a M.D of Radiology; and another daughter is a P.T.D of Physical Therapy. Mick Rich Contractors has constructed medical facilities for over 40 years.
