SANTA FE, N.M. — Regulators on Thursday opened a 10-day period for health insurance companies to submit new rates or bow out of New Mexico’s state-run exchange.
Though the rates have not been disclosed, people shopping for insurance under the Affordable Care Act could see higher prices and fewer choices next year, as key federal insurance subsidies and enforcement provisions are left in political limbo.
Here are some things to know about New Mexico’s evolving insurance market:
A COMPETITIVE MARKET
About 55,000 New Mexico residents buy their insurance through the state exchange, known as beWellnm, and 200,000 are eligible to participate.
New Mexico has sustained a competitive health insurance exchange with four private providers. They include one of five remaining cooperatives in the country formed under a loan through the Affordable Care Act, called New Mexico Health Connections. Others are Blue Cross Blue Shield of New Mexico, Molina Healthcare and Christus Health Plan.
Blue Cross and Blue Shield of New Mexico says it is working with state and federal regulators to “achieve a stable and sustainable market.”
Martin Hickey, CEO of New Mexico Health Connections, says insurance companies are struggling to estimate the financial risks and rewards of the marketplace.
Insurance providers have been left to guess whether the federal government will continue to pay subsidies for out-of-pocket expenses such as copayments and deductibles for lower-income patients. Those payments are separate from income-based tax credits that help people buy coverage.
An end to subsidies could drive up exchange rates and cause healthy consumers to abandon coverage.
As Congress attempts to overhaul the nation’s health care system, it remains unclear whether President Donald Trump’s administration will require that taxpayers maintain coverage or pay a penalty.
Hickey is concerned about a potential cycle of rising premiums and fewer healthy participants in the marketplace.
Cynthia Cox of the Kaiser Family Foundation said insurers may exit New Mexico to avoid a guessing game about federal subsidies and regulations that could lead to financial ruin.
By late June, New Mexico residents will learn from the Office of the Superintendent of Insurance how much insurers intend to increase premiums.
Providers can revise rates again in July, and still have until late-September to cancel participation in the exchange.
Health care experts say there should be less pressure to increase premiums in New Mexico than most places because so many low-income residents receive health care through Medicaid.
More than a quarter-million state residents have enrolled in Medicaid since the program’s expansion in 2014.