New Mexico

Last spring I wrote up a deep dive into New Mexico's proposed Medicaid-based Public Option (called "Medicaid Forward"):

Medicaid Forward would allow residents whose incomes are too high to qualify for Medicaid to instead purchase an affordable plan through the program. Medicaid is a robust, comprehensive program that already provides high-quality care to nearly 50% of our residents. Expanding this simple and trusted system will make healthcare less expensive for people of all backgrounds.

...Medicaid Forward is a good deal for New Mexico. New Mexico can raise its current Medicaid income limit and the federal government will still match nearly 73% of the costs. For the remaining costs, participants will pay for coverage on a sliding scale based on their income.

...Medicaid Forward would open Medicaid so every resident has access to affordable care. We envision a New Mexico where every person, regardless of their background or income, has the opportunity to live their healthiest life.

As I noted at the time:

BeWell NM

via BeWell NM, New Mexico's state-based ACA exchange:

The annual report, as mandated by the 2021 New Mexico Statutes Chapter 59A, Article 23F, Section 59A-23F-10, and compiled jointly by beWellnm, New Mexico’s Health Insurance Exchange, and the New Mexico Office of the Superintendent of Insurance (NM OSI), offers a comprehensive analysis of various key aspects. These include the individual health insurance market, both on- and off-Exchange enrollment, small business enrollment, qualified health plan pricing, outreach and enrollment assistance activities, as well as strategies aimed at addressing the challenge of the remaining uninsured population in New Mexico.

Overview of the Individual Health Insurance Market

This one is particularly frustrating. In addition to the filings being listed at the federal Rate Review website, every individual & small group market carrier also has their filings listed via the SERFF database and via New Mexico's own internal, searchable rate filing database...and yet I still can't run a weighted average rate change for either market because almost none of the filings at any of these three databases includes the actual enrollment data (Presbyterian on the individual market is the exception).

As a result, I have to once again settle for unweighted averages, which come to +5.6% on the individual market and +7.7% for small group plans.

A few weeks ago, I reported that both Nevada and Oklahoma had placed insolvent insurance carrier Friday Health Plans under receivership, leaving just two states left to do so (North Carolina and Colorado, which happens to also be the home to Friday's corporate headquarters).

It turned out that I was correct about Oklahoma, but had jumped the gun slightly re. Nevada; the insurance commissioner had petitioned the court to put Friday into receivership, but hadn't actually done so yet.

Well, it turns out my error re. Nevada has been rendered moot as of yesterday; via the Nevada Division of Insurance:

JUNE 21, 2023 - Court orders receivership for Friday Health Plans of Nevada


Wow. It took less than 12 hours from this announcement by the COLORADO Dept. of Regulatory Agencies to be released...

Friday Health Plans, Inc. Winding Down Business

What Happened?

Friday Health Plans, Inc., the parent company of Friday Health Plan of Colorado, ,Inc. (HMO), has announced that it will begin to wind down its business activities throughout the country, working in close conjunction with state regulators, including the Colorado Division of Insurance.

In recent months, it became apparent that the parent company would need to raise substantial capital to continue. Friday was ultimately unable to raise that capital and on June 1, Friday Health Plans, Inc. (Parent) stated publicly that they would begin to wind down. this press release from the NEVADA Division of Insurance:


October 2022:

Texas: Friday Health Plans Bails; Another ~230K Enrollees Will Have To Pick A Different Day Of The Week

It was just four days ago that Bright Healthcare, which had been aggressively expanding their individual market coverage area footprint as recently as a year ago, suddenly announced that they were doing a complete 180 and instead pulling out of virtually the entire individual & small group markets nationally starting in January 2023.

...Well, just one day after the Bright Healthcare bombshell news broke, Texas-based health insurance broker Jenny Chumbley Hogue sounded the alarm on another large carrier bailing on Texas next year:

And its confirmed. Email received from Friday. Buckle up folks! Individual OEP in Texas is going to be a bumpy ride!

UPDATE 3/8/23: HB 400 just overwhelmingly passed the New Mexico House!

HUGE NEWS! #HB400 just passed the House Floor by a vote of 58-10! Huge thanks to Rep. @reenaszcz & Speaker @JavierForNM for their work carrying #MedicaidForward through the House of Representatives & to everyone who reached out to their legislator. On to the Senate! #nmleg #nmpol 

— NM Together for Healthcare (@NMT4HC) March 8, 2023

BeWellNM Logo

New Mexico's state-based ACA exchange, BeWell NM, has posted a powerpoint from a special Board of Director's meeting that they had last week.

For the most part it's unremarkable and full of inside baseball wonkery:

  • They're replacing WebEx with Zoom for video meetings
  • They're gonna split their Comms & Outreach into two separate divisions
  • They're preparing for the upcoming Medicaid Unwinding project

There's two items which are more noteworthy, however.

First, New Mexico is one of only three state-based marketplace (SBM) which handle premium bill payments as well as enrollment functions. The other two are Rhode Island and Massachusetts. Washington State's HealthPlanFinder tried dealing with payments within the exchange itself as well for a few years but eventually gave up on it due to it causing too many technical & administrative headaches.

BeWellNM Logo

via beWell NM, New Mexico's ACA exchange:

A classic tax-season scam is back with a new twist. Clients in New Mexico have reported receiving calls from scammers posing as beWellnm representatives, trying to obtain private and secure information.

BeWellnm, New Mexico’s health insurance exchange, will never call and ask a customer to text or email your bank information, credit card or social security number.

“Customers who received insurance through the exchange will need a 1095-A form – Health Insurance Marketplace Statement – for their taxes. Scammers know this and think they can take advantage, but we are here to protect consumers and offer them free help with their 1095-A form,” said Bruce Gilbert, Chief Executive Officer of beWellnm.

BeWellnm will be providing customers who obtained insurance through the exchange at any point last year with their 1095-A form. You should expect to see if in the mail in the coming weeks. This form is very important and will be filed with your federal taxes to complete Form 8962: Premium Tax Credit.