New Mexico Mercury

The Health Insurance Exchange is the only mechanism we have at the moment to extend health care to the uninsured and I was as disappointed as anyone with the Federal Exchange’s inability to handle the high volume of hits to its website and then to fix the problems two weeks into implementation.  I hear it is getting better but still not smooth sailing.

So why does the Federal Exchange affect our State’s Health Insurance Exchange? 

It stems from the fact that New Mexico was more than a little late in setting up the Exchange.  The Governor had been convinced she could do it through Executive Authority but with Legislative pressure (including threat of a lawsuit) she agreed to support bi-partisan legislation at the last legislative session. So in March of 2013, we had an official State Exchange – states like California and Colorado had set theirs up two years ago the moment funding became available; we had hardly moved off the dime. With just six months to D-day (October 1), the state asked CMS to recognize its Exchange but proposed that at the outset, New Mexico would first create the system to accommodate employer enrollment (SHOP) this year, and use the Federal Exchange for individual enrollment for one year, i.e. until October 2014.  The Feds agreed to this and also agreed to designate us a “State Exchange” so that we could access funding to train health guides who would help people enroll and for community outreach. Because New Mexico depends on the Federal Exchange for individual enrollment, we have been seriously affected by the problems on that site. 

The NM SHOP or small employer exchange however is working fine and has enrolled over 500 employers with over 1,000 employees. 

In the meantime:  If you want to enroll as an individual, call the toll free number which is staffed 24/7,  at 1-855-99-NMHIX or talk to one of the health guides that are listed on the website http://www.nmhix.com/business-partners/health-care-guides/. Health Guides are managed mainly by non-profit groups and should be able to give you advice on how to proceed, including whether or not you can make a paper application.  Remember, you have till December 15th to apply. Coverage starts January 1, 2014.  You can continue enrolling until March of 2014.

Who runs the New Mexico Exchange? 

There have been some concerns about the Board that runs our Exchange.  There are thirteen members on this Board – six appointed by the Legislature, five by the Governor, and two by statute. Because of a flaw in the way the law was written there are three insurance company representatives.  The names of Board members are at:  http://www.nmhix.com/nmhix-board/exchange-board-members/. So while there are more insurance members than we originally planned, they are outnumbered by 10 other members.  By the way, I would urge readers to keep an eye on Board meetings and agendas and to attend meetings which are all open to the public. You should also note there is time set aside for public comment at the end. Holding the HIX Board’s collective feet to the fire is a definite public right, and I would say, given the stakes, an obligation.

In my last column, I suggested that you use a health guide or a broker to help you maneuver through the choices:  they both come at no cost to the user.  (See my column on how to prepare for enrollment:  "Countdown to Health Reform III").  The Kaiser Foundation’s subsidy calculator can help to estimate eligibility for subsidies:  http://kff.org/interactive/subsidy-calculator/ .This tool is also available on www.bewellnm.com (Cost Calculator). 

So when will the Federal Exchange be ready? 

I tried accessing the www.healthcare.gov site and I could go all the way through to set up an account – I did not set up an account because I am not eligible to purchase anything on the HIX.  This suggests that they are able to get you ready to select a plan. 

Fingers crossed that it begins to function as it should. It could make a huge difference to tens of thousands of New Mexicans.

The NMHIX is meeting this Friday from 10 am to 5 pm at CNM Workforce Training, 5600 Eagle Rock Ave NE. People should check the agenda and come if they wish for all or part.

(Photo by jfcherry)