New Mexico health insurance exchange
Unique, hybrid approach to health insurance marketplace in New Mexico
By Louise Norris
November 29, 2013
By the beginning of November, exchange applications had been completed for more than 7,500 New Mexicans, and 172 of them had selected private plans. But New Mexico is also expanding Medicaid, and by November 5 the state had approved 2,507 new Medicaid applications.
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.)
Because the individual side of the New Mexico exchange is operating in partnership with HHS, Healthcare.gov is used to enroll. The glitches in the federal website have meant that many NM residents have not been able to create accounts or compare coverage options. In response, on October 10th, Be Well New Mexico added a message on their website letting visitors know that they can call 1-855-99-NMHIX for personal assistance with individual coverage, and they’ve also 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 being able 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.
New Mexico health insurance exchange links
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.