Health Insurance Uncertainty Has Carriers And Consumers In Limbo

OPENCLIPART-VECTOR VIA PIXABAY / CREATIVE COMMONS LICENSE

  • Sarah Trujillo
  • Thursday, June 8, 2017

As Republicans work to fulfill their promises to repeal and replace the Affordable Care Act, the future of healthcare in the U.S. is up in the air. In New Mexico, health insurance carriers have to submit their proposed premium rates by this weekend. After state officials review them, the public will have 10 days to weigh in.

Beth Hanes had to get new health insurance after her husband died last year. She works as a writer and non-clinical nurse and she doesn’t get health insurance through her employer, so she bought a plan on the exchange. She said she’s lucky she’s in good health.

“So I’m a very low consumer of healthcare and so I can buy one of those high-deductible plans to try and keep it affordable,” Hanes said. “But a lot of people can’t.”

Hanes went to New Mexico Health Connections, one of four insurance carriers available on the state exchange. Her premiums have increased and she said a bloated bureaucracy could make them go up more and if insurance carriers pull out of the exchange, as they’ve done in some other states.

“I don’t qualify for Medicaid, unless something catastrophic happened,” Hanes said. “I have 9 years to go before I would qualify for Medicare, so what else could I do?”

The House GOP health plan would eliminate government subsidies for low and middle-income people buying insurance on exchanges. The Senate has yet to propose other plans for replacing Obamacare, so it’s still the law of the land, for now.

That lack of predictability is also affecting insurance carriers as they prepare to submit their proposals for health insurance premium rates for 2018.

“The more uncertainty the federal government perpetuates,” Martin Hickey, CEO of New Mexico Health Connections said. “The more of that’s gonna get built into that first round of rates.”

Hickey said he believes in the legislative process, but that it’s taking an awfully long time. They’re assuming the subsidies will be eliminated and are working that into their premium calculations.

“You have to price for uncertainty,” Hickey said. “Otherwise if you haven’t brought in enough premium, then you can’t pay the providers and it just gets very ugly.”

But Hickey has vowed they will offer plans on the exchange next year, even if the subsidies are cut.

“Which I feel terrible about, because that means higher rates for New Mexicans,” Hickey said.

The other carriers on the state exchange wouldn’t comment for this story. Blue Cross Blue Shield was down for an interview, but later refused. Molina also refused, and both carriers cited uncertainty as the reason for why they didn’t want to talk to us. Christus Health Plan didn’t reply to our email.

Kika Peña is with the state Office of the Superintendent of Insurance.

“We’re trying to keep the marketplace stable in an unstable environment,” Peña said.

Peña said they held a workshop last month with all the carriers and she got the impression they’re going to stay in New Mexico, although she said they have received no official word. The law may change, she said, but for now the process for insurance carriers is the same.

“We’re monitoring what’s going on in Washington, seeing what the changes are,” Peña said. “But we truly are doing business as usual because nothing has truly changed.”

Yet.

Republican Congressman Steve Pearce is the only member of New Mexico’s U.S. House delegation to vote for the GOP health care plan. He agreed to an interview but canceled the night before and now his office is not responding to our requests.

Insurance carriers have until Saturday to submit their first round of premium rate proposals. The superintendent will review them and take public comments on the rates starting July first. Carriers will then be able to amend their proposals.

KUNM’s Public Health New Mexico project is funded by the W.K. Kellogg Foundation and the McCune Charitable Foundation.

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