State official talks health insurance

STAFF REPORT

Time is running out for small business owners and individuals to sign up for health insurance coverage before penalties kick in, according to officials from New Mexico’s health insurance exchange, Be Well New Mexico.

The fines for no insurance coverage are going up annually and essentially doubling next year, according to Zach Hale, an outreach specialist from Albuquerque representing Be Well New Mexico.

While the number of people enrolled in marketplace insurance in New Mexico is rising, not all the people that apply are getting coverage, according to the U.S. Department of Health and Human Services (HHS), which said more than 79,000 people applied for marketplace insurance as of March 2015, yet only 52,000 received coverage.

Hale gave a presentation at the Portales Public Library Tuesday morning to inform small business owners and individuals of their health insurance options.

“One of our missions is to make sure that all New Mexicans without health insurance get insured,” Hale said. “Most Americans are changing jobs and income levels all the time, which could mean a lot of different health plans over a lifetime.”

According to Hale, the employer mandate goes into effect in 2016, which means businesses with over 50 employees have to provide health insurance or pay a fine.

Hale talked about the challenges small businesses have when it comes to health insurance.

“You want everyone to be healthy and working, but health insurance is tricky; it’s expensive, it’s complicated and hard to administer,” he said. “A new option is making sure employees find their way on the individual market by using local experts, known as brokers and enrollment counselors. They steer individuals towards the plan that would suit them best.”

Hale also noted the Small Business Health Options Program, or SHOP, a group employer plan through Be Well New Mexico where small businesses are taking advantage of buying power that were previously only held by large companies.

According to Hale, if an individual’s job doesn’t offer insurance, they may still be able to get insurance through a spouse, or a parent (if under age 26). To find out more information, their spouse or parent would have to contact their job’s human resource office.

Hale said individuals with low income can enroll in a comprehensive insurance known as Medicaid at anytime, and even if they don’t qualify, their children still have a good chance.

“Medicaid has been newly expanded to include everyone up to roughly 138 percent of the poverty level,” he said. “Before, it covered 100 percent of the poverty level and very discreet groups of people.”

Hale said marketplace insurance is the option for everyone who makes too much to qualify for Medicaid, doesn’t have access to employer coverage or Medicare or veterans benefits.

New Mexico’s official health insurance exchange, BeWellNM.com, is the place where five different insurance companies compete for individual people’s business, he said.

Hale said the website offers dozens of options to choose from, along with financial and free expert help.

“Open enrollment for the exchange starts on Nov.1 and lasts until Jan. 31, but you can enroll now if you have a special qualifying life event, such as divorce, marriage, a job change, etc.,” he said.

The (HHS) reported in June that the number of people receiving marketplace health insurance in New Mexico had risen by almost half in the last five months with 52,358 people having enrolled with 51 percent of the enrollees being new. The number of people enrolling in 2014 was a little over 32,000.

Shelby Venson, an employee of the Center for Medicare in Washington D.C., said at the time that 80 percent of people receiving their insurance through HealthCare.gov get their insurance for $100 or less per month.