'If the rates go up 20 percent, I would not be surprised, since we are the third lowest state in rates now' – New Mexico Insurance Superintendent John Franchini
Blue Cross Wants Back into N.M. Individual Health Plan Market
BY DENNIS DOMRZALSKI
After sitting out a year on New Mexico’s health insurance exchange because it couldn’t get a 52 percent rate hike, Blue Cross and Blue Shield of New Mexico is looking to get back on the exchange for 2017.
The insurer is one of five companies that have filed preliminary rates for individual plans for 2017 for the exchange, Superintendent of Insurance John Franchini told ABQ Free Press. The other companies that have filed are New Mexico Health Connections, Presbyterian Health Plan, CHRISTUS Health Plan and Molina Healthcare of New Mexico. Those four firms sold policies on the exchange this year.
The preliminary rates aren’t yet public and will most likely be adjusted by Franchini’s office, but a source told ABQ Free Press that two insurers are seeking average rate increases of 28 to 30 percent. Another is asking for increases of up to 80 percent, and two are asking for increases in the 3 to 12 percent range.
Franchini said the rates will be made public by the end of the month. After that, the insurers will have an opportunity to further adjust them. The final rates for 2017 will have to be approved by Franchini’s office by mid-June.
Franchini said he couldn’t confirm the rate increase figures given to the newspaper, but he added, “If the rates go up 20 percent, I would not be surprised, since we are the third-lowest state in rates now.”
Big Rate Hikes Expected Nationwide
Health care experts have been predicting hefty rate increases on the insurance exchanges for next year. Several large insurers, including UnitedHealthcare, have said they are having trouble making a profit on exchange customers. That’s primarily because people who buy through the exchanges have been sicker than anticipated and have needed more health care than initially thought.
In April, UnitedHealth said that by 2017 it would exit most of the 34 insurance exchanges it sells in. The company said it lost $475 million on the exchanges in 2015 and expects to lose $500 million this year.
Lots of Federal Subsidies
If New Mexico’s exchange rates do rise by 20 to 30 percent, most people who buy individual plans through the exchange won’t pay the full price. That’s because 68 percent of the 54,865 people who bought policies on the exchange this year received a federal premium subsidy, according to the U.S. Department of Health and Human Services. The average subsidy in New Mexico was $205 a month, meaning that a policy holder actually paid an average premium of $127 a month.
People who buy on New Mexico’s exchange are eligible for premium subsidies generally if they make between 200 and 400 percent of the federal poverty level and can’t get health insurance through their employers.
Last year, Blue Cross asked Franchini’s office for a 51.7 percent increase for its exchange policies for 2016. Franchini offered the company a 24 percent increase, which it rejected. “I cannot approve a rate increase if I can’t prove it actuarially,” Franchini said at the time. “The public has to have someone in government to protect them.”
After failing to get its rate hike, Blue Cross bailed on the exchange for 2016. That meant that more than 35,000 New Mexicans had to find a different insurer.
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