Presbyterian returning to state health care exchange

Copyright © 2021 Albuquerque Journal

Nearly five years after leaving New Mexico's insurance exchange, the state's largest locally owned health plan will be available through beWellnm during the upcoming open enrollment period.

After announcing it would leave state insurance at the start of 2017, Presbyterian Health Plan is reentering the marketplace. Jeffery Bustamante, CEO of beWellnm, confirmed to the Journal that New Mexicans would be able to choose between PHP and other plans on the exchange, with associated subsidies that make those plans more affordable.

"We always welcome additions to the exchange," Bustamante said. "We're proud to offer that competitive market of private insurers."

PHP, which has more than 610,000 New Mexicans enrolled in its Medicaid, commercial and individual plans, originally announced its departure from the exchange in 2016, citing affordability concerns.

Since then, Presbyterian Health Plan President Brandon Fryar told the Journal the health care organization has since retooled its offerings to make them more affordable, and will be entering the state's revamped exchange in a year when the number of New Mexicans shopping for insurance is expected to increase dramatically.

"You're going to see likely a lot of individuals and families looking for affordable coverage on the exchange now post-pandemic," Fryar said.

The federal Families First Coronavirus Response Act provided states with the option to extend Medicaid eligibility to uninsured people and increased the federal share of Medicaid spending during the public health emergency associated with the COVID-19 pandemic. As a result, Medicaid enrollment has soared in New Mexico over the last year-and-a-half. Data from the New Mexico Human Services Department shows that enrollment increased from 830,165 in February 2020 to 939,126 in August 2021, a jump of more than 13%.

"We've not seen growth like that in the Medicaid program since the expansion under the Affordable Care Act," Fryar said.

However, Fryar said the expanded coverage is expected to expire in 2022, which could leave a chunk of New Mexicans needing insurance on the exchange during open enrollment. Open enrollment begins Nov. 1.

"That's why the timing is right for us to make sure that we can sustainably serve those members," Fryar said.

Fryar added that people shopping for insurance on the exchange tend to be sensitive to insurance premiums. He said Presbyterian has focused on keeping the premiums low.

Bustamante said the state exchange has made changes ahead of open enrollment. Starting this year, New Mexicans will use beWellnm's website, rather than , to shop for and compare health plans. New Mexicans can access a range of private plans through .

"The real win here is that it helps New Mexicans, everywhere from Union County to Bernalillo County to wherever you may be, have options," he said.

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