A Look At New Mexico's Planned Insurance Exchange

Jan 28, 2013

New Mexico plans to establish a state-run health insurance exchange and Republican Gov. Susana Martinez's administration is taking steps to implement it this year.

Some questions and answers:

Q: What is the exchange?

A: It's envisioned as an online, one-stop shopping center for individuals and small businesses to buy health coverage from private insurance companies. Those plans must have a package of health benefits tailored to New Mexico, and the exchanges are to make it easier to compare plans by price, benefits and quality. For people without Internet access, the exchange will have so-called navigators to help New Mexicans on the phone or in person. The government will offer premium subsidies for individuals based on their income and tax credits for some employers.

Q: How many people lack health insurance in New Mexico?

A: A fifth of the state's population, about 400,000 people. Only three other states — Texas, Nevada and Louisiana — had higher uninsured rates last year, according to the Census Bureau.

Q: How many individuals will be able to use the exchange?

A: It's estimated that nearly 200,000 New Mexicans may be able to buy health insurance through the exchange between 2014 and 2020. Some uninsured won't need to use the exchange because they will become eligible for health care through Medicaid, which New Mexico is expanding under terms of the federal health care law that provides for insurance exchanges. However, illegal immigrants aren't eligible for Medicaid and can't buy insurance through the exchange.

Q: How many businesses will use the exchange?

A: The state estimates there are about 28,000 small businesses with 50 or fewer employees, and only about 30 percent offer health insurance to their workers.

Q: When will the exchange be ready?

A: The state says it's on track to meet an October deadline for starting to enroll people into the exchange, which must be fully operating by January 2014. Officials in the Human Services Department have said the New Mexico exchange initially may focus on making insurance available through small businesses and that it could take a bit longer to serve individuals. However, the state says three-fourths of uninsured households have at least one full-time or part-time worker, which potentially could give them access to insurance through an employer.

Q: How is the state establishing its exchange?

A: The Martinez administration doesn't plan to establish a new agency to run the exchange. Instead, the exchange will be operated by the New Mexico Health Insurance Alliance, a nonprofit public corporation established in 1994 to provide access to insurance for small businesses and some individuals. However, some lawmakers and health care advocates contend that state law must be changed by the Legislature for the alliance to operate and implement the exchange. Attorney General Gary King has said the law authorizing the alliance doesn't conform to federal requirements for the exchange.

Q: How much will the exchange cost?

A: The state received a $34 million federal grant for an exchange, and has spent about $2 million so far. Much of the money is expected to go for a computer system that will be used by New Mexicans to shop for health plans. The alliance hasn't yet selected contractors for the computer system and to manage implementation of the exchange.

Copyright 2013 The Associated Press.