OPINION: Lawmakers should extend state assistance for health care costs

When I saw our new health insurance premium, I burst into tears.

Last year, my family paid $1,063/month for coverage through New Mexico’s health insurance exchange, BeWell. This year, when the federal subsidies expired, that premium would have jumped to $2,550/month without the state stepping in. That’s more than our mortgage, property taxes and homeowners insurance combined ($2,218), resulting in an $18,000 annual increase. There’s no version of our budget where that works.

On paper, our household income puts us at 713% of the federal poverty level for a family of three. To some policymakers, that number might suggest we’re “doing fine.” But numbers without context tell the wrong story.

My husband and I are both self-employed. He’s an acupuncturist running a small practice and employing a single mom. I’m a nurse and have spent my career helping people navigate health care systems and access care. Because of my own health conditions, I now work from home as an entrepreneur.

We live carefully. We drive older used cars, cook at home, rarely eat out and don’t take fancy vacations. We’ve worked hard, stayed on top of our finances and saved. We are not living a life of luxury — we are living a life of responsibility.

And still, the cost of health insurance nearly knocked us off our feet.

If I had employer-based insurance, the average total cost of family coverage would be about $22,000 a year — but mostly covered by an employer. The employee share averages closer to $6,800 annually. As a self-employed family, we shoulder nearly the entire cost ourselves. Even with state assistance this year, we’ll pay close to $18,000 in premiums alone, before deductibles, copays and coinsurance.

Health care isn’t optional for my family. I live with multiple chronic conditions, including fibromyalgia, migraines, gastrointestinal issues and postural orthostatic tachycardia syndrome. I manage chronic pain, fatigue and episodes that can make it impossible to function without accommodations. I’ve worked full time through illness for years, until managing my health made that unsustainable.

I also carry a strong family history of breast cancer. Every year, my risk increases. I’ve reached a 30% lifetime risk, and cannot risk being uninsured.

When New Mexico stepped in with temporary premium assistance, our monthly increase dropped approximately $400 — still difficult, but manageable compared to the more than $1,400 increase we initially faced. I was relieved and grateful. Then I learned the assistance only lasts through June, and proposed income caps could still push families like mine off a cliff.

This is what policymakers need to understand: income caps create affordability cliffs. The difference between paying 9.6% of our income for coverage and 17% isn’t minor. It’s the difference between stability and constant fear, between staying insured and gambling with our health.

I’ve seen what happens when people fall through the cracks from lacking health insurance. I’ve also seen what happens when people gain coverage through the exchange: preventive care, manageable conditions and fewer hospitalizations. Letting affordability protections expire midyear or imposing arbitrary income cutoffs would bring the chaos back.

New Mexico lawmakers have stepped in before when federal policies fell short. Lawmakers should do so again by extending state premium assistance beyond June and rejecting arbitrary income caps that would push working families off coverage.

I don’t care what political party you belong to. I want you to get care when you need it. No family should have to choose between paying the mortgage and keeping their health insurance. Lawmakers must act now to keep care affordable and within reach, for my family and countless others like us.

Carmen Meyer has lived and worked in Albuquerque for over 30 years as a registered nurse and is currently self-employed as a health care consultant.