New Mexico: Notes of interest from BeWell NM's board meeting

Tue, 12/03/2019 - 12:20am

A couple of weeks ago, BeWell NM, the name of the New Mexico ACA health exchange, held their latest board meeting. There's two key things to keep in mind about New Mexico:

First, they've been officially operating as a state-based exchange while "piggybacking" off of HealthCare.Gov since the very first Open Enrollment Period in 2013-2014...but they announced over a year ago that they're following Nevada's (and Idaho's) lead in splitting off onto their own full exchange, starting in 2021.

Second, as I reported back in August, there was an unusual development on the New Mexico ACA individual market:

CHRISTUS HEALTH PLAN LOSES QUALIFIED HEALTH PLAN STATUS

...“CHRISTUS Health Plan failed to achieve compliance with requirements for certification as a qualified health plan,” announced New Mexico Superintendent of Insurance John G. Franchini, on Monday, August 19th. “The term ‘qualified health plan’ signifies a high standard. It indicates that a health insurance plan is compliant with federal and state requirements and is therefore eligible to participate on the New Mexico health insurance exchange. Four other carriers in the state were able to meet the requirements, and we are disappointed that this year, CHRISTUS was not.” said Superintendent Franchini. The Superintendent added that the determination would not affect the ability of CHRISTUS to continue the sale and service of its Medicare Advantage products in the state.

CHRISTUS Health Plan currently offers coverage to approximately 1,100 of the over 56,000 New Mexicans in the individual market. Pursuant to state law, OSI will require CHRISTUS to alert its New Mexico members that their plans will terminate on December 31, 2019. Individuals who need to select new coverage can shop for a plan or find enrollment assistance through New Mexico’s Health Insurance Marketplace, either online at www.bewellnm.com or by calling 1-833-862-3935 toll-free.

With both of those in mind, here's some interesting tidbits from the BeWell NM board meeting on November 15th. These are basically just taken from their slideshow presentation:

Considerations for 2020 Projections National

CMS is no longer doing projections. Historically they have done national projections on plan selections and effectuation, which included Congressional Budget Office (CBO) projections.

The lack of fine associated with being uninsured impacting people’s decision-making.

Texas v Azar

Public Charge

Considerations for 2020 Projections New Mexico

Plan Discontinuance

• CHRISTUS will no longer be offering plans on the individual exchange.

Their enrollment was approximately 1,000-1,400 members.

Effect on re-enrollment is unknown.

beWellnm has been, and continues to be, proactive to educate and encourage

these individuals to take action to remain covered.

Our projection is based on multiple data sources:

National Projections from the Congressional Budget Office.

Correspondence with New Mexico on-Exchange carriers about their projections.

Quantitative analysis of national and local projections. Qualitative analysis of our current environment and factors that may impact enrollment (Plan Discontinuance).

The average enrollment projection accounts for effectuation, and the month-to-month fluctuations in enrollment. It is the median point between an entire range of what is most likely to happen. The number aligns with both national and local projections.

New Mexico had exactly 45,001 QHP selections during the 2019 Open Enrollment Period.

For the 2020 OEP, BeWell NM is projecting:

32,500 - 35,500 renewals by existing enrollees
12,000 - 14,000 new enrollees
A total of 44,500 - 49,500 QHP selections during 2020 OEP
a 15% net drop-off between plan selection & effectuation, for...
actual effectuated enrollment of 38,000 - 42,000 people in 2020.

Several slides are devoted to BeWell NM's "Native American Program" of outreach to the Native American community, which is obviously especially important in this state. One item which I found very interesting is this brochure showing the differences between coverage under the Indian Health Service and ACA exchange policies (sorry for the poor resolution...these are blown up from small screen shots within the PDF):

As for New Mexico's move to their own full state-based exchange, there's some more updates on that as well:

Individual Exchange Build Update

• October 10th, 2019 the Exchange kicked off the individual exchange project!

– Kick-off meeting was well received

– Thanks to Secretary Scrase his opening remarks

• Individual Exchange Build Update

Discussion of Map & Gap Sessions

Accomplishments

hCentive Staffing Plan approved

Final comments received on remaining PMP documents

Map & Gap Analysis Sessions underway, no major issues to note

Map & Gap Sessions with HSD participation setup

PMO and Be Well reviewed Deliverables Tracker and assigned review team members to each deliverable

• Highlights for next six weeks

Obtain signoff on all PMO documents

Align and baseline Project Schedule with hCentive, PMO, IV&V tasks

Continue Map & Gap Analysis sessions

IV&V conducts first health-check review starting, 11/18

hCentive analyzes notes/concerns from January 2019 stakeholder meetings

Coordinate Carrier and other stakeholders outreach plan including Premium Billing

• NMHIXEscalationNeeded

None at this time