ALBUQUERQUE, N.M. — Editor’s note: This story has been updated to include a comment from the U.S. Department of Health and Human Services.
Copyright © 2014 Albuquerque Journal
About 30,000 New Mexicans are about to see their individual health insurance plans go away – part of a statewide push to ensure all coverage sold here meets minimum requirements of the Affordable Care Act.
Blue Cross Blue Shield of New Mexico last week issued a letter to members currently covered by individual insurance plans that don’t meet the standards set by the health care law. That includes about 13,000 customers whose plans had been grandfathered because they were in place before ACA was enacted in 2010.
The notice alerts members that their plans will be discontinued effective Jan. 1, 2015, and that they need to select a new plan that complies with ACA, according to Janice Torrez, vice president of external affairs and chief of staff at Blue Cross.
Another 10,000 Blue Cross members also will see their individual plans discontinued. Torrez said those people have known for the past year the change was coming.
We’re “moving our (affected) members toward selecting other plans,” Torrez said. “There are so many plans available that I believe that members are going to find something that’s going to fit their needs.”
Presbyterian Health Plan currently has 6,800 members on individual plans that don’t meet ACA standards. The company will in the next two weeks send letters to those members to let them know their plans are going away and alert them to their options for the future, a representative said.
The change follows a May order by New Mexico Insurance Superintendent John Franchini that all plans sold in New Mexico after Dec. 31 must comply with ACA standards. Franchini on Monday said he made that decision after discussions with executives from Blue Cross and Presbyterian. He called ACA-compliant plans more “robust” – especially for those facing catastrophic injury or illness – and said there are plenty of options available for New Mexicans whose plans will cease to exist as of January.
“We got together and said, ‘This would be the right time to make sure all the citizens in the state who had a plan that wasn’t ACA-compliant would have the opportunity to convert to one,’ ” he said. “I look at this as a positive thing, not as a negative.”
The federal government wouldn’t have required the discontinuation of grandfathered, non-compliant plans for another two years, according to a spokesman for the U.S. Department of Health and Human Services.
HHS “gave insurance commissioners and insurance companies the choice to renew pre-Affordable Care Act health plans until October 2016,” HHS spokesman Ben Wakana said in an emailed statement.
Some customers have objected to losing plans they say fit their needs and budget and being required to buy plans that have coverage they don’t believe they need at a sometimes higher cost.
Blue Cross and Presbyterian representatives could not say what their affected members are currently paying for their individual plans, as premiums depend on a variety of factors.
Those losing their individual plans have the option to shop for coverage on the New Mexico Health Insurance Exchange, a marketplace of plans offered by five different insurance companies, including Blue Cross and Presbyterian. Open enrollment for 2015 begins on Nov. 15.
Premiums for plans on the exchange vary widely, but some buyers can qualify for subsidies. The Kaiser Family Foundation found that 83 percent of exchange enrollees in 2014 qualified for some form of federal subsidy.
“I think there are many opportunities for people to save money and increase their benefits,” Franchini said.
Exchange plans come in four categories – platinum, gold, silver and bronze. Higher premiums generally mean lower deductibles, copayments and other out-of-pocket expenses.
About 32,000 New Mexicans signed up on the exchange for coverage in 2014.
For more information, visit the exchange website at www.bewellnm.com