New Mexico health exchange health rates rise, but subsidies increasing

Oct. 16—New Mexicans who get individual medical coverage on the state health care exchange — including many self-employed people — will see hefty base rate hikes starting in January, but a significant expansion in subsidies should keep most from feeling the pain.

Individual market customers, whose ranks also include some employees at small companies that don't offer health coverage, will see an average 10.2% rate increase in 2025 across exchange plans from four insurance companies, according to the New Mexico Office of the Superintendent of Insurance. Viara Ianakieva, the office's life and health division director, said state subsidies for the exchange's so-called "Turquoise Plans" are now available to those earning up to 400% of the federal poverty level, compared to 300% previously.

While the subsidies won't increase in dollar amount, Ianakieva said the expansion means more New Mexicans should have access to those plans on BeWellnm, the state's exchange marketplace.

The state is projecting about 39,000 people will qualify and enroll in Turquoise Plans in 2025. About 33,000 are currently enrolled, according to Ianakieva, including many who earn between 300% and 400% of the federal poverty level.

"If you made 350% over the federal poverty level last year, you wouldn't have qualified," Ianakieva said, while going forward that same person would be able to access the subsidized plans, thanks to increased funding from the Legislature.

Subsidies, both state and federal, are what make individual plans affordable for self-employed New Mexicans, including Santa Fe's many artists, said Barry Hatfield, a longtime Santa Fe insurance broker. Hatfield said he expects few people will suffer as a result of the higher base rates, unless they have a substantial increase in income and earn over the subsidy limit.

"The people who don't get a subsidy, they're not going to be very happy," Hatfield said. "But there's nothing they can do."

According to the state, individuals making less than $30,000 a year or a family of four making up to $62,000 will have access to at least eight Turquoise Plans with a premium under $10 a month, while those making up to $45,000 a year or a family of four making up to $93,000 a year can choose from six Turquoise Plans for under $25 a month.

Many New Mexicans qualify for premiums of less than $10 per month, and some for no cost at all, depending on their financial situation, Ianakieva said.

The four insurance companies — Blue Cross and Blue Shield of New Mexico, Molina Healthcare of New Mexico, Presbyterian Health Plan and United Healthcare of New Mexico — have also won approval for an average rate hike of 9% for small group plans, which are available for employers with between two and 50 full-time equivalent employees, according to the office.

However, New Mexico employers with fewer than 50 full-time equivalent employees aren't required to provide health insurance, Hatfield noted.

"If you're a small business here with let's say 10 employees, you do not have any incentive to get health insurance" for employees, Hatfield said, adding that many small employers just advise their workers to get individual health plans on the exchange.

Open enrollment runs from Nov. 1 through Jan. 15 for New Mexicans. More details about the exchange are available at bewellnm.com.

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