NM marketplace for insurance opens this week

September 30, 2013 • State News

SANTA FE, N.M. (AP) — For a state that’s long struggled with one of the nation’s highest uninsured rates, New Mexico has a lot at stake with a new health insurance marketplace that starts enrolling customers on Tuesday.

Individuals and small businesses — those with 50 or fewer workers — can begin to shop for insurance through a health insurance exchange that’s intended as a one-stop shopping center for health coverage offered by private insurers. Coverage would begin in January.

Enrollment can be done online by going to the state exchange’s website ( ), by telephone or in person at about 160 locations across the state, mainly medical clinics and hospitals.

Nearly a fourth of New Mexico’s population lacks health insurance. Only five states had a higher rate last year, according to the Census Bureau.

Although the uninsured are the primary target of the [auth] exchange, it’s available to others as well.

Individuals who buy their own insurance or obtain it through an employer can go to the exchange to compare costs and purchase coverage if they a find plan that’s more affordable or better suited to their health care needs. Immigrants living in the country illegally are barred from buying through the exchange, however.

Exchange officials estimate more than 80,000 New Mexicans may enroll in an insurance plan through the exchange in its first year and more than 200,000 by 2020.

Some uninsured — potentially 90,000 next year and perhaps 170,000 over several years — will end up obtaining medical care through Medicaid, which the state is expanding starting in January to cover more low-income adults. When people seek coverage through the exchange, they’ll be directed to Medicaid if they’re eligible for the program.

“I am really hopefully that we’ll cut our uninsured rate in half this first year and as word gets out and as more and more people avail themselves of these programs we’ll really see a dramatic drop in the uninsured rate to something much more like what it should have been all along,” said Sen. Gerald Ortiz y Pino, an Albuquerque Democrat who sponsored legislation this year to create the exchange.

Initially, New Mexico is operating a state-run exchange for small businesses to shop for coverage for their employees but will use a federally operated exchange to enroll individuals for the next year.

The insurance plans available to individuals, however, will be specifically tailored to New Mexico. Individuals can go to the state exchange website to begin to shop for plans and they will automatically be linked to the federal government’s exchange to complete the application process.

One potential complication has arisen that could create problems in heavily Hispanic New Mexico. The federal website’s Spanish-language version won’t be ready for online enrollment for a few weeks.

But New Mexico’s call center and in-person enrollment sites will offer help for Spanish speakers.

“I am hopeful that our infrastructure, both through the call center as well as the enrollment assisters, can help bridge that gap for the time being,” said Jason Sandel of Farmington, vice chairman of the exchange’s 13-member governing board.

But Sandel is bracing for glitches in the early days of the exchange.

“Is it going to be seamless? Is it going to be perfect? Absolutely not. The only way we are going to be able to overcome those challenge is for folks to give us feedback so that we can improve,” said Sandel.

Related Posts

Leave a Reply

« »