This guide provides an overview of the New Mexico Health Insurance Exchange including the history of the exchange, how the exchange will operate, and exchange information for New Mexico residents and small businesses.
Beginning in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges (also called health insurance marketplaces).
Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state health insurance exchanges.
All states have three options for setting up a state health insurance exchange for 2014:
New Mexico originally entered into a unique state-federal partnership. New Mexico ran the small business "SHOP" exchange, and the federal government ran the individual health insurance exchange.
New Mexico launched its own state-based health insurance exchange, BeWellNM, in 2021.
New Mexico planned to offer a state-based health insurance exchange for both the individual and small business SHOP Exchange. Final legislation was signed into state law in March 2013 that authorized New Mexico to establish and operate a state-based health insurance exchange.
However, with the deadline approaching to have exchange infrastructure in place, New Mexico did not have the proper technology up and running to operate the individual exchange. In May 2013, the governing board voted to partner with the federal government on the individual health insurance exchange. Even with the federal government operating the individual exchange, New Mexico will retain oversight of the all exchange plans, rates, and carriers. According to the New Mexico Health Insurance Alliance (NMHIA), the Exchange will aim to take over the individual exchange by 2015.
BellWellNM officially launched in 2021.The New Mexico Health Insurance Exchange for individuals will be operated through a state-run health insurance exchange called BeWellNM. Starting in 2021, New Mexico residents will be able to access information about all the plans available through the exchange.
According to an estimate by healthcare.gov in 2013, 360,293 or 21% of New Mexico’s non-elderly residents are uninsured, of whom 334,339 (93%) may qualify for either tax credits to purchase coverage in the Exchange or for Medicaid if New Mexico participates in ACA Medicaid expansion. NMHIA estimates that 200,000 will purchase coverage through the New Mexico Health Insurance Exchange by 2020.
The New Mexico Health Insurance SHOP Exchange for small businesses will be state-operated and will be available to employers with up to 50 employees.
All plans offered through the New Mexico Health Insurance Exchange will meet the ACA definition of a Qualified Health Plan (QHP). The plans will be offered by level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis. The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%) and Platinum (plan pays 90%).