By Louise Norris
January 23, 2014
By December 28, 7,688 people had finalized their private plan selections in the New Mexico exchange. 26% of them had enrolled without any financial assistance – a higher rate than the national average of 21%. An additional 12,327 applicants were eligible for the state’s expanded Medicaid program. In the first three months of open enrollment, exchange applications were completed for 33,258 people, although many of them had not yet finalized their plan selections. More than 21,000 of those individuals applied in December, following an aggressive marketing campaign by the exchange and dramatic improvement in Healthcare.gov’s performance.
Five private carriers are offering a total of 23 plans in New Mexico’s exchange: Health Care Service Corporation, Lovelace Health System, Molina Healthcare of New Mexico, New Mexico Health Connections and Presbyterian Health Plan. The lowest cost bronze plan in the NM exchange averages $217 a month, quite a bit lower than the national average of $249.
New Mexico settled on a unique approach to its health insurance marketplace. For individuals seeking health insurance, the state is operating Be Well New Mexico in partnership with the federal government. Small businesses use the state-run SHOP exchange. The state had previously announced that it would run all aspects of the exchange on its own, the exchange board determined in May that it did not have enough time to get computer systems up and running. (While Utah is also using a hybrid approach, the specifics are different. Utah is leaving the individual exchange exclusively to the federal government and operating the small business exchange on its own.)
By December 31, the state-run SHOP exchange had enrolled 340 people, including 207 employees and 133 of their dependents. Nearly 1500 small businesses had started their applications in the SHOP exchange, and several thousand employee names had been entered into the system, so total enrollment is likely to grow substantially over the next few months as employers settle on a plan. The SHOP enrollment is in addition to the people who are enrolling in coverage through the HHS-run individual exchange.
Because the individual side of the New Mexico exchange is operating in partnership with HHS, Healthcare.gov is used to enroll. Enrollees can also call 1-855-99-NMHIX for personal assistance with individual coverage, and the exchange created a website where consumers can see average prices for individual plans in order to get an idea of what’s available from the five participating insurers without having to access the full services at Healthcare.gov.
New Mexico’s path to establishing an exchange was atypical. New Mexico Gov. Susana Martinez, a Republican who opposes the federal health reform law, has been the driving force in establishing an exchange and advocating for the state-run model. Martinez designated that the Health Insurance Alliance develop the state exchange. The Health Insurance Alliance is a nonprofit association of health plans created by the state Legislature in 1994 to offer health insurance coverage to small employers. In mid-March, the Senate and House both approved a state-run exchange.
The state expects 200,000 people to purchase insurance through the exchange. According to Kaiser’s statehealthfacts.org, 417,000 New Mexicans — 21 percent of the population — are uninsured.
Guide to the New Mexico Health Insurance Exchange
Includes details about carriers, important dates, eligibility and enrollment information
New Mexico Health Insurance Exchange
Administrative and start-up information
State Exchange Profile: New Mexico
The Henry J. Kaiser Family Foundation overview of New Mexico’s progress toward creating a state health insurance exchange.
Let your New Mexico governor and legislators know how you feel about the state’s proposed health insurance exchange.New Mexico Governor Susana Martinez