New Mexico puts the screws to #ShortAssPlans, hoping to lock in ACA protections
In September 2018, the New Mexico Office of the Superintendent of Insurance (OSI) and Health Action NM (an advocacy group for universal access to health care) presented details about potential state actions to stabilize the individual market. OSI has the authority to regulate some aspects of the plans, including maximum duration, but they noted that legislation would be needed for other changes, including minimum loss ratios and benefit mandates.
New Mexico’s insurance regulations were amended, effective February 1, 2019, to define short-term plans as nonrenewable, and with terms of no more than three months. The regulations also prohibit insurers from selling a short-term plan to anyone who has had short-term coverage within the previous 12 months.
...In January 2019, HB285 was introduced by Rep. Micaela Cadena (D, 33rd District) in an effort to much more closely regulate short-term plans in New Mexico. The legislation passed out of committee with unanimous support in February.
HB285 includes the same durational and sales limits that the state has already implemented via regulation, but it goes further than that. The legislation would also give OSI the authority to regulate a wide range of provisions related to short-term plans, including minimum loss ratios and minimum standards as far as benefits that would have to be covered by the plans.
But that's not all! via Andrew Oxford of the Sante Fe New Mexican:
House Democrats are sponsoring legislation that would write several provisions of the Affordable Care Act into New Mexico law with hopes that no matter what happens at the federal level, the state can keep in place some of the standards for covering mental health care, for example, and protections for patients with pre-existing conditions.
...HB 436 would put into state law a requirement that anyone who applies for a plan must be offered one regardless of pre-existing conditions. And it would bar plans from charging more to patients based on pre-existing conditions.
The bill, crafted with staff from the state Office of the Superintendent of Insurance, also would outline essential health benefits that plans must cover, including emergency services and mental health care.
There you go. That checks off the three biggest parts of the 3-legged Stool's Blue Leg: Guaranteed Issue, Community Rating and Essential Health Benefits.
...Other lawmakers are aiming to put some more specific provisions of the Affordable Care Act into state law: those on contraception.
HB 89, sponsored by Rep. Debbie Armstrong, D-Albuquerque, would require health insurance plans to cover most contraceptive medications and devices without charging patients out of pocket.
Of course there's also the Big One:
...Similarly, New Mexico legislators are also considering a bill that would allow consumers who earn too much money to qualify for Medicaid to buy a plan under the program — what’s known as a “Medicaid buy-in.”
But the state would be on its own for now to finance such a system.
This last point is critical--the odds of the Trump Administration approving federal funding for a Medicaid buy-in are, shall we say, slim, so it's up to the state itself.