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New Mexico health exchange attracts additional competitor

SANTA FE — New Mexico’s largest health care provider said Tuesday it has applied to re-enter the state’s federally subsidized insurance exchange for individuals and families after a two-year absence, potentially providing consumers with increased options.

Presbyterian Healthcare Services spokeswoman Melanie Mozes said the company has submitted proposed premium rates to state insurance regulators.

In a statement, Brandon Fryar, Presbyterian Health Plan’s president, said the organization is “currently evaluating re-entering the Health Insurance Exchange and will be reviewing several factors between now and mid-July to make a final decision.”

The Office of the Superintendent of Insurance said four current providers have applied to return to the exchange in 2019, and that Presbyterian’s application would add a fifth insurance carrier if approved. New Mexico has sustained a competitive health insurance exchange as consumer options have dwindled across some other states.

Agency spokeswoman Heather Widler said exchange insurance proposals are under initial review and that more details will be made public later this month. Proposed premiums for consumers can be revised again in July, and providers can drop out as late as August. Enrollment typically takes place in November and December.

Presbyterian currently participates in the insurance exchange for small businesses and provides off-exchange individual policies, Widler said. The company last participated in the exchange in 2016.

Almost 50,000 people receive insurance through the state’s health exchange portal, known as beWellnm. About 70 percent of those people receive subsidies.

Average premium increases set records this year on the exchange, partly as a result of President Donald Trump’s decision to pull the plug on federal payments that reimburse insurers for reduced copays and deductibles they’re required to provide to people of modest means.

Premiums for mid-level insurance coverage increased by an average of more than 35 percent in 2018, though low- and zero-premium insurance plans have been available for people of limited means.

More recently, Republicans removed a requirement that most Americans maintain health insurance coverage or risk fines. Many experts believe the number of uninsured nationwide will increase when repeal of the so-called individual mandate goes into effect in 2019.

In all, about 250,000 New Mexico residents are eligible for exchange coverage under the Affordable Care Act because they do not get health care through employers, Medicaid or other sources.

New Mexico’s expansion of Medicaid in 2014 helped cut in half the number of uninsured residents.




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