In an effort to save money and time, the state will soon start negotiating with the federal government to redesign Medicaid.

Proposals include a "personal responsibility initiative," which uses incentives and disincentives to improve the program. Patients who use the emergency room for nonemergencies would be punished with pricier co-pays, for example.

But Quela Robinson, a lawyer with the New Mexico Center on Law and Poverty, says the state is lacking data to show who's using the emergency room and why.

"If anything, it shows us there's a lack of providers," Robinson tells SFR.

She also says many take offense to the words "personal responsibility."

"The name has an assumption that patients are lazy and getting fat on Medicaid, which isn't the case," she says.

A more controversial initiative that's been discussed is the "superwaiver," which would consolidate all program waivers, such as medically fragile and developmentally disabled, into one. Fritzi Hardy, whose daughter receives treatment under the developmentally disabled waiver, strongly opposes the idea.

"I don't want my corner of the world telling people with AIDS how to live," Hardy tells SFR. "The whole Medicaid redesign smacks of 'We want to cut services and money and blame you for being poor and sick.'"