Short-term health plans in New Mexico
- New regulations limit short-term health insurance in New Mexico to three months, bans renewals, and prohibits sale to anyone who has had a short-term plan in the past 12 months.
- Plans with longer terms approved prior to February 2019 were allowed to be sold in New Mexico until late April 2019, but must terminate no later than the end of 2019.
- As of mid-2019 there appears to be no short-term health insurance plans for sale in New Mexico.
- Legislation enacted in 2019 will further regulate short-term health insurance in New Mexico.
- National General offered short-term plans in New Mexico through early 2019, but plans are no longer for sale as of mid-2019.
In January 2019, HB285 was introduced by Rep. Micaela Cadena (D, 33rd District) in an effort to much more closely regulate short-term plans in New Mexico. The legislation passed with unanimous support in both the House and Senate, and was signed into law by Governor Lujan Grisham in March 2019.
HB285 includes the same durational and sales limits that the state has already implemented via regulation, but it goes further than that. The legislation also gives OSI the authority to regulate a wide range of provisions related to short-term plans, including minimum loss ratios and minimum standards as far as benefits that have to be covered by the plans, including state-mandated benefits.
Short-term health plan duration in New Mexico
Amended regulations, effective February 1, 2019, define short-term health insurance in New Mexico as nonrenewable, and with terms of no more than three months. The regulations also prohibit insurers from selling a short-term plan to anyone who has had short-term coverage within the previous 12 months.
The Trump administration began allowing short-term health insurance plans to be offered with extended durations as of October 2, 2018, unless a state had its own restrictions. At that point, New Mexico did not yet have its own limits on short-term plans. So for a few months, short-term plans with initial terms of up to a year were available for purchase in the state.
But in September 2018, the New Mexico Office of the Superintendent of Insurance (OSI) and Health Action NM (an advocacy group for universal access to health care) presented details about potential state actions to stabilize the individual market. OSI has the authority to regulate some aspects of the plans, including maximum short-term plan duration, but they noted that legislation would be needed for other changes, including minimum loss ratios and benefit mandates.
The new rules took effect at the beginning of February 2019, but 12-month short-term plans were still for sale at that point via various online brokerages. The New Mexico Office of the Superintended of Insurance (OSI) confirmed that while the new rules for short-term plans did take effect in February, there were still plans for sale that were approved prior to that date, and those could continue to be sold under their already-approved terms. But any new plans that are submitted to state regulators for approval must have term limits of no more than three months, and be non-renewable, and OSI clarified in April 2019 that insurers had to immediately stop selling non-compliant short-term plans. Any such plans that had already been sold must terminate no later than December 31, 2019.
By mid-2019, a search of various online brokerages indicated there was no short-term health insurance in New Mexico being sold. There are other states (California, Washington, Colorado, and Hawaii) where regulations for short-term plans have been strengthened since 2018 and insurers have abandoned the short-term market.
Which insurers offer short-term plans in New Mexico?
The New Mexico Office of the Superintendent of Insurance has confirmed, in bulletin related to HB285 implementation, that while compliant short-term health plans may continue to be sold, they cannot be renewed. But as noted above, there do not appear to be any short-term plans for sale in the state as of mid-2019.
National General still offered short-term health insurance in New Mexico as of March 2019, and at that point, their plans were still available with initial terms of up to a year. As noted above, this was because those plans were approved by the state prior to the effective date of the state’s new rules for short-term plans, and the state stopped allowing those plans to be sold as of April 2019. By mid-2019, National General’s plans were no longer available.
Blue Cross Blue Shield of New Mexico was offering short-term plans as of early 2019, but the insurer’s sales department confirmed in March 2019 that short-term plans were no longer for sale. It was unclear whether that was a temporary change or if the plans had been permanently removed from BCBSNM’s product line.
Who can get short-term health insurance in New Mexico, and when should I consider it?
Since short-term health plans are not currently available in New Mexico, we advise you to check you’re eligibility for a special enrollment period which would allow you to sign up for an ACA-compliant major medical plan.
There are many qualifying life events that will trigger a special enrollment period allowing you to buy a plan through the health insurance marketplace in New Mexico. These plans are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months before another policy takes effect (with a premium subsidy if you’re eligible).
Based on income you may also qualify for health insurance in New Mexico under expanded Medicaid coverage. When the Affordable Care Act was enacted in 2010, Medicaid expansion was a cornerstone of lawmakers’ efforts to expand realistic access to healthcare to as many people as possible. If you have a household income up to 133 percent of poverty (138 percent with the 5 percent income disregard) would be able to enroll in Medicaid.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.