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New Mexico health insurance

Uninsured rate in NM among highest, but falling thanks to ACA

  • By
  • contributor
  • November 2, 2014

If you live in New Mexico – or you’re considering living there – you’re probably interested in issues that impact the overall health of the state’s residents. Quite a few factors might affect your own perception of the state’s attitudes toward providing health coverage and health care.

We’ve put together a partial list for your consideration.

New Mexico health ratings

The Commonwealth Fund’s Scorecard on State Health System Performance 2014 rated New Mexico 36th among the 50 states and District of Columbia – down one spot from 35th in 2009. New Mexico’s Scorecard includes details on how the rankings are determined.

The most recent edition of America’s Health Rankings (2013) also measured the state’s “healthiness” and ranked New Mexico 32nd out of the 50 states. New Mexico’s rating is increased by low levels of air pollution, low rates of death from cancer, and relatively high levels of per capita public health funding. But it’s lowered by factors that are mainly socio-economic: low rates of high school graduation, and high percentages of the population living in poverty or without health insurance.

Trust for America’s Health has compiled additional details on overall public health in New Mexico; check out the 2014 listing of Key Health Data About New Mexico

In terms of healthcare affordability and access, a Commonwealth Fund study puts New Mexico last in the nation.  Think New Mexico launched a healthcare initiative in 2014 aimed at solving that problem and specifically tackling the issue of affordability and access.  They recommend steps that will help to bring more price transparency to healthcare, and also more fairness by prohibit providers from charging different prices for the same procedure depending on who is paying the bill.

New Mexico and the Affordable Care Act

In 2010, both of New Mexico’s U.S. Senators – Tom Udall and Jeff Bingaman – were supportive of the health reform law. In the House, two Representatives voted yes: Martin Heinrich and Ben Lujan. The third Representative, Harry Teague, voted no. Heinrich has since replaced Bingaman in the Senate, and the House has two new Representatives from New Mexico: Michelle Lujan Grisham and Stevan Pearce. Grisham supports the ACA, but Pearce opposes it. He is currently the only member of the New Mexico congressional delegation that opposes the ACA.

At the state level, Republican Governor Susana Martinez was initially opposed to the individual mandate portion of the ACA, but has moved forward with Medicaid expansion under the law and is working with her Democratic legislature to implement the ACA without obstruction in New Mexico. For individual coverage, New Mexico is one of a handful of states operating a partnership exchange – called Be Well New Mexico – together with the federal government. For small businesses, the state is running its own SHOP exchange.

How did the ACA help New Mexicans?

In 2012, about 24 percent of non-elderly New Mexico residents were uninsured – the fourth highest rate in the country. Several studies have predicted an average drop of about 4.7 percentage points after ACA implementation, to a rate of about 19.6 percent. New Mexico is predicted to still have one of the highest uninsured rates in the country, but it’s clear that the ACA – and specifically Medicaid expansion – is helping to increase the number of people in the state who have health insurance.

New Mexico enrollment in QHPs

In November 2013, the Kaiser Family Foundation estimated that the potential market for the exchange in New Mexico was 193,000 residents, and that 118,000 of them would qualify for premium subsidies to lower the cost of their coverage. By mid-April 2014, when the first open enrollment period ended, 32,062 people had finalized their enrollment in the New Mexico exchange, and HHS reported that 78 percent of them received subsidies to lower their premiums.

New Mexico received a federal grant of nearly $77.4 million under the ACA to create a Consumer Operated and Oriented Plan (CO-OP). In total, more than $2 billion was awarded for CO-OP creation, but only 22 states participated. New Mexico Health Connections is the newly-created CO-OP, offering plans for sale in the New Mexico exchange along with three other carriers: Blue Cross and Blue Shield of New Mexico, Molina Healthcare of New Mexico, and Presbyterian Health Plan. In late July, the state announced that CHRISTUS Health Plan of Texas would be joining the exchange for the 2015 open enrollment that begins in November, bringing the total number of carriers to five.

New Mexico Medicaid/CHIP enrollment

Expanding Medicaid eligibility to 138 percent of poverty has been a key component of Obamacare success in New Mexico. The state agreed to accept federal funding to expand Medicaid under the ACA, and as of early 2014, it was estimated that nearly 48 percent of the uninsured population in New Mexico would be eligible for expanded Medicaid or CHIP. As of mid-April, 30,147 people had enrolled in Medicaid through the New Mexico exchange. Enrollment in Medicaid continues year-round, so that number is continuing to increase, further lowering the uninsured rate in New Mexico.

Does New Mexico have a high risk pool?

Before the ACA, individual health insurance was underwritten in nearly every state, which meant that pre-existing conditions could prevent a person from obtaining a policy, or could result in significantly higher premiums or policy exclusions. The New Mexico Medical Insurance Pool (NMMIP) was created to give people an alternative if they were unable to obtain individual health insurance because of their medical history.

Now that the ACA has been implemented, all health insurance plans are guaranteed issue, making high risk pools largely obsolete. But NMMIP is one of a few state-run risk pools that is still operational and has no plans to terminate coverage. They are anticipating a significant rate increase at the start of 2015 (a rate increase of nearly 24 percent was scheduled for July 2014 but has been deferred until January), which will probably help to encourage policy holders to switch to a plan offered through the exchange instead.

State-based health reform legislation

Here’s a summary of recent New Mexico bills related to healthcare reform: