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AZTEC — San Juan County will still operate a fund that partially pays health care providers' uninsured medical claims even though commissioners approved deep cuts to those reimbursements.

The cuts were approved during a Tuesday meeting.

And, even with the cuts, the fund, now called the health care assistance program, is expected to have about a $900,000 deficit by fiscal year 2016, according to county documents.

"We really didn't have an option on doing this," commissioner Keith Johns said. "With the state's actions, we don't have anywhere to go."

The county commissioners changed health care reimbursement rates from 70 percent to an averaged Medicaid rate of 33 percent and narrowed eligibility requirements.

The New Mexico Legislature passed Senate Bill 268 in its recent session, unrolling the Safety Net Care Pool. The safety net pool requires that counties pay one-twelfth of 1 percent of their gross receipt taxes into the fund, which is designed to help finance hospitals' uncompensated health care claims.

Some counties have expressed reluctance to comply with the new law and San Juan County officials have vocally protested the law.

The required payment will pull about $3 million from its projected $4.2 million health care program. The county must also pay from the same source about $2.1 million to the state's Medicaid fund.

A projected $4 million reserve now bolsters the health care program, but, after a year, it will be depleted and ultimately show a deficit.

Deputy County Executive Officer Linda Thompson said that deficit is based on expected health care program claims. She said those claims and the deficit could decrease if more county residents enroll in Medicaid.

County Executive Officer Kim Carpenter has said enacting a partial one-eighth of 1 percent gross receipt tax, among other changes, is "highly possible."

The tax is projected to create almost $1.5 million for the health care program, according to county documents.

Before the commission unanimously approved the revisions, Chairman Jack Fortner told those gathered in the chambers that the changes can be revised. He said how much money the San Juan Regional Medical Center receives from the safety net pool is uncertain, and that could influence the health care program's reimbursement rates.

Carpenter has said the law that created the safety net pool pits counties against counties and counties against the state. He said state officials never provided enough information for the county to properly budget for the mandated payments.

"The bottom line is this is a very poor plan in transition," Carpenter said.

Dan Schwartz covers government for The Daily Times. He can be reached at 505-564-4606 and Follow him @dtdschwartz on Twitter.