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Insurance rate hike sets record for New Mexico exchange

Superintendent of Insurance John Franchini

ALBUQUERQUE, N.M. — It looks like Obamacare premiums for New Mexico policyholders will spike by double digits in 2018.

Regulators have approved the largest health insurance premium increase in the four-year history of New Mexico’s subsidized exchange, state Insurance Superintendent John Franchini said. Average premium increases for 2018 will range from 36 percent to 41 percent for mid-level insurance coverage, according to an analysis by his office.

The state’s top insurance regulator said the rate increases in 2018 are heavily influenced by uncertainty about whether the federal government will block or discontinue payments to insurers. President Donald Trump has repeatedly threatened to halt these reimbursements to insurance companies in his drive to dismantle the Affordable Care Act, as Obamacare is formally known.

About 55,000 New Mexico residents sign up each year for insurance through the state’s exchange, known as beWellnm.

Back in the marketplace for 2018 are Molina Healthcare, Blue Cross Blue Shield of New Mexico, Christus Health Plan, and New Mexico Health Connections — the same as this year. Between them, the providers are offering 216 individual plans in the new enrollment year. This year, there were 179 individual plans on offer.

About 60 percent of people who buy insurance through the New Mexico exchange qualify for subsidies that reduce costs. “I feel sorry for the other 40 percent though,” Franchini said. “Forty percent have to pay the full brunt of the rate increases.”

The full range of premium increases runs from 17 percent to just over 49 percent.

“Instability: that’s the main reason for the increases. We’re trying to give carriers some sort of certainty,”said Franchini, whose office told the insurers to assume Cost Saving Reduction payments would not continue. Insurance companies receive the payments to defray the cost of premiums for clients who qualify for subisidies.

Raising premiums gives insurers more confidence to participate in the market by protecting them from major financial losses, said Franchini. At the same time, if the Trump administration continues to make the CSR reimbursements (or if Congress steps in to appropriate the necessary funds), these insurers could potentially reap a windfall, financed largely by federal taxpayers who pick up the tab for the cost-sharing program.

If the CSRs do come through, could the rate hikes be rolled back? “I cannot guarantee that will happen in New Mexico,” Franchini said, adding that insurance and medical companies “don’t do well” with revising contracts once they’re signed.

“The continued volatility and chaos in health insurance market creates an extraordinarily challenging business environment for health insurers,” said Dr. Martin Hickey, CEO New Mexico Health Connections, whose company has the second-largest number of enrollees on the exchange — about 35 percent. Molina is the market leader with about 37 percent.

“Health plans are doing the best they can to navigate in the current climate,” Hickey said. “As a result of the United States House of Representatives v. Price lawsuit, the administration has the ability to revoke the cost-sharing reduction payments at any time, which wreaks havoc for health plans trying to manage risk.”

Franchini said rates are rising because not enough people are buying insurance through New Mexico’s federally subsidized marketplace.

Material from the Associated Press was used in this report.

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