State announces rates for 2027 Affordable Care Act plans

The New Mexico Office of Superintendent of Insurance has approved 2027 rates for individual market Affordable Care Act plans sold on and off BeWell, the New Mexico Health Insurance Marketplace.

The average increase is 24.4 percent; OSI scrutinized the rates and they are actuarially sound, as required by federal and state laws, according to a news release.

“Rising health care costs and inflation are continuing to affect consumers nationwide and New Mexico is no different. Despite the rate increase, I can assure you that the rates for all the insurance companies are actuarially sound, nondiscriminatory and transparent,” said Superintendent of Insurance Alice Kane. The rate increase is higher than the nationwide median of 15 percent, the release stated. New Mexico’s premiums, however, have historically been lower than most other states’. The rate increase and historically lower premiums result in premiums that are now in line with the rest of the nation before subsidy assistance. It is important to note that 92 percent of BeWell enrollees are eligible for state and federal premium subsidies based on income.

New Mexico’s Health Care Affordability Fund will continue to provide financial assistance to eligible New Mexicans. In 2027, the HCAF is expected to provide ongoing premium and cost-sharing relief for BeWell enrollees, helping to mitigate the impact of the rate increase. Federal and state premium assistance will continue to play a significant role in safeguarding the affordability of health insurance.

“Our state’s uniquely comprehensive benefits such as behavioral health services and prior authorization prohibitions contribute to the rate increases,” a spokesperson said. “Insurance companies cannot charge cost-sharing for in-network behavioral health services or require prior authorization for certain behavioral health services. Removing cost-sharing and prior authorization requirements promotes utilization, which initially increases premiums but will save costs and improve overall health outcomes in the long-term.”

The key factors that contributed to the rate increase this year include:

· Higher than expected 2025 New Mexico claims experience, which is the foundation for the 2027 rate development.

· Higher utilization and inflation impacted healthcare costs services, which impacts medical services and pharmaceutical costs nationwide.

· Upward trending of brand-name drugs and biologicals, which often provide advanced therapies, comprised 85 percent of overall drugs costs in New Mexico.

Turquoise Plans continue to provide additional savings on deductibles and co-pays, according to the release. Standardized “Clear Cost” plans also continue to be offered and feature consistent cost-sharing structures, regardless of the insurance company, making it easier for BeWell enrollees to compare plans.

During the open enrollment period, from Nov. 1 to Jan. 15, BeWell enrollees can schedule an appointment at be wellnm.com/appointment and have a certified assister guide them through finding a plan that is right for their needs.

Visit bewellnm.com Nov. 1 to compare plans and prices.

Be on the lookout for your BeWell renewal letter at the start of open enrollment, the release stated.

Make sure your income information is upto-date and report any changes throughout the year as soon as possible.

Call 833-862-3935 to speak to someone or make an appointment at bewellnm.com/appoint ment.

The rates take effect Jan. 1, 2027. The insurance companies offering coverage in New Mexico will remain the same: Health Care Service Corporation (dba BCBS NM), Presbyterian Health Plan, United Healthcare of New Mexico, and Molina Health Care of New Mexico.

For more information, visit the Office of Superintendent of Insurance website at osi.nm.gov.

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