New Mexico

This is an excellent overview of how healthcare pundits, politicos, reporters and industry folks are keeping a very close eye on the ACA exchanges this weekend, as the December 15th deadline for January coverage approaches (well, for most states, that is; 6 states now have deadlines later than the 15th). It's well worth a read, as it goes into the whole "manual renewal" vs. "autorenewal" issue and a whole mess of other stuff.

However, towards the end are two additional data points:

CMS officials, including Marketplace CEO Kevin Counihan have been reassuring about auto-enrollment, said Martin Hickey, CEO of New Mexico’s co-op health plan. “It’s a stressor, but I haven’t seen him biting his fingernails,” Hickey said of Counihan. “But you never know.” His own health plan has had 3,ooo people sign up as of Dec. 10 through HealthCare.gov and the pace is picking up.

There's been a lot of fuss made about 2015 ACA exchange premium rates not being available at Healthcare.Gov until after the election. The presumption, of course, is that this is being done for political reasons. While this may be true, it could also simply be that there's a lot of different policy figures to plug into the federal system, and some states haven't even finalized their rates yet.

That being said, residents of some states can check out the 2015 premiums now and compare them against their current premium:

IDAHO: Idaho is the only state moving from HC.gov to their own exchange. Idaho residents can check out their 2015 rates directly via the state exchange site.

CALIFORNIA: CoveredCA has 2015 rates available right now as well.

When I last checked in on New Mexico's Medicaid expansion program, they were at around 55% of the total eligible. As of late August (judging by the Sept. 1st byline on the article), that number was up to 71%:

New Mexico projected that Medicaid expansion would sign up 219,000 new enrollees over a six-year period. In the first year alone (2014), they have already signed up 155,000, 71% of the best-case six-year estimate. 

This is really just a confirmation of an entry from 3 weeks ago, but this time I have more specifics on the premium changes at hand in New Mexico:

Among the five insurance carriers participating in the exchange, premiums will drop on average by 7 percent at Molina Healthcare, 1.5 percent at New Mexico Health Connections and 1 percent at Blue Cross and Blue Shield of New Mexico, according to the state Office of the Superintendent of Insurance.

The highest, lowest and roughly mid-range monthly payments for HMO health insurance plans offered by companies participating in the New Mexico Health Insurance Exchange. The payments are based on charges for a 50-year-old, non-smoking resident of the Albuquerque metro area for 2015. For more information, go to the exchange website atwww.bewellnm.com.

Premiums will be unchanged at Presbyterian Health Plan. The fifth insurance carrier participating in the exchange, Christus Health Plan, is in its first year.

This Just In...3 out of the 5 insurers operating on the New Mexico ACA exchange are dropping their 2015 premium rates. A fourth is increasing theirs, and the fifth one is new. The overall average is a 1-2% drop, although I can't tell whether that's a weighted or unweighted average (neither the enrollee breakdown nor the actual % change for the individual companies is included in the article):

Individual health insurance premiums in New Mexico will drop by an average of 1 to 2 percent in 2015 for those who buy on the state’s health insurance exchange, New Mexico Superintendent of Insurance John Franchini said Wednesday.

Franchini’s office released the new individual rates from the five insurers that will be selling on the exchange. Three of those insurers – New Mexico Health Connections, Blue Cross and Blue Shield of New Mexico and Molina Healthcare of New Mexico – saw some decreases in their overall rates from this year, said Aaron Ezekiel, head of Affordable Care Implementation for the Office of the Superintendent of Insurance.

Presbyterian Health Plan had some increases, Ezekiel said. CHRISTUS Health Plan is new to the exchange.

Nice find by Esther F. The main focus of the story is that a 5th insurance company has decided to join 4 others on New Mexico's ACA exchange, which is of course good news for competition, the free market and so forth...

The newest insurer is CHRISTUS Health Plan of Texas, Franchini said during a meeting of the NMHIX board in Santa Fe.

“CHRISTUS is a nonprofit and they will be on the exchange. They will be the fifth carrier on the exchange,” Franchini said.

CHRISTUS will join New Mexico Health Connections, Presbyterian Health Plan, Blue Cross and Blue Shield of New Mexico and Molina Healthcare of New Mexico as the firms that will sell in the individual exchange.

...however, Esther notes a potentially far more significant section of the story farther down. The backstory is this: New Mexico has been planning on running their own exchange for the 2nd year of open enrollment, but has more recently been having second thoughts given the various technical issues faced by some of the other state exchanges. Therefore...

Some good news (relatively speaking) on the Massachusetts front: As you'll recall, the state which inspired the ACA (ironically due to the program being spearheaded by then-Governor Mitt Romney), and which has been operating under their state-level version of the law smoothly for some years now, had an incredibly embarrassing misfire with their ACA-specific exchange website. After hobbling through the first enrollment period (and leaving over 200,000 residents in healthcare limbo as a result), it was determined that the existing site was such a mess that they had two choices: Either replace the existing software with an entirely new system, or drop the whole thing and move over to the Federal exchange as Oregon is doing.

Instead, Massachusetts decided to hedge their bets and pursue both: They've been working with a new vendor to rebuild their own exchange from scratch, while simultaneously arranging for a quick move to HC.gov just in case Plan A doesn't work out.

The good news is that so far, anyway, the new platform seems to be working out in early testing, though it's way too early to be sure of anything:

Another Medicaid update out of New Mexico:

An estimated 220,000 New Mexicans are eligible for expanded Medicaid benefits, and 121,000 of them signed up for the newly available coverage. Many of them found their way to Medicaid by visiting the insurance exchanges online, by talking with guides, or at enrollment events designed to encourage use of the exchange.

As I noted yesterday, there are three states which had unusually large discrepancies between the official HHS and state exchange QHP enrollments:

  • New York came in over 65,000 lower than the number I had for a simple reason: The New York exchange lumps enrollees in their Child Health Plus program in with QHPs, even though technically this isn't a QHP program. There were over 40,000 of these as of the end of February; this number has climbed to 65,028 as of 4/19.
    Since Child Health Plus is privately funded (and therefore isn't on the Medicaid/CHIP side), but also isn't officially a QHP either according to HHS, I've moved it over to the "Off Exchange QHP" column.

Impressive numbers from New Mexico during the extension period:

Nearly 35,000 New Mexicans had enrolled in health plans through the state and federal insurance exchanges as of April 15, a 32 percent increase from the end of March, the New Mexico Health Insurance Exchange said Friday.

As of March 31, 24,412 residents had enrolled through the exchanges, and as of April 15, that number had climbed to 34,966, as 8,554 residents took advantage of the extended enrollment period, NMHIX said.

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