Updated: 2021-04-10 by
It's not too late! Affordable Care Act (Obamacare) enrollment is OPEN in New Mexico until August 15.
The Biden administration has announced a special enrollment period for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period will run from February 15 to August 15. In addition, a new federal law, The American Rescue Plan Act of 2021 (ARPA), increases premium subsidies, provides free health insurance if you’re unemployed in 2021, and waives excess subsidy payments for the 2020 tax year.
This website provides information about these new programs as well as other facts about getting health insurance under the Affordable Care Act (ACA), including:
- whether you must get health insurance
- what the available plans cover
- how much coverage will cost
- how to sign up for a plan
- how to get help if you need it.
To begin, keep in mind these key points about health insurance in New Mexico:
1. New Mexico open enrollment has ended, but you can use the COVID special enrollment period to get covered.
Because of the COVID-19 pandemic, beWellnm will be open for Affordable Care Act signups from February 15 to August 15, 2021. You can use this special enrollment period to get new coverage or change plans. And you don't need to have a qualifying event to use this enrollment window. Anyone eligible to use beWellnm can sign up.
To learn more about enrollment, see How To Sign Up for Obamacare in New Mexico.
2. You may qualify for new health insurance premium subsidies.
On March 11, 2021, President Biden signed the American Rescue Plan Act. The law provides $1.9 trillion of federal aid to Americans still struggling with the COVID-19 pandemic. The relief measures include additional premium subsidies for those who purchase health insurance under the Affordable Care Act. Here’s a quick summary of the two types of available subsidies, including updates under ARPA:
Federal tax credits. Until the passage of ARPA, the ACA provided premium subsidies only for those whose income fell between 100% and 400% of the federal poverty level. (For example, the cutoff for a family of four in New Mexico was $104,800. For an individual, it was $51,040.)
Now, no individual or family will have to pay more than 8.5% of their household income for a mid-level “silver” plan purchased from beWellnm. Even though the amount of the subsidy is based on a silver plan, you can apply the subsidy to any marketplace plan, including bronze, gold, or platinum plans. The subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums when you purchase a plan through beWellnm.
These enhanced subsidies are retroactive to the start of 2021, but they're also temporary. They will last only through 2022 unless Congress enacts legislation to extend them.
Cost-sharing subsidies. More than half of the people who purchase coverage through a health insurance exchange receive "cost-sharing reductions" (CSRs). These subsidies automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital. CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2021 health plans, that means a family of four in New Mexico can't earn more than $65,500 and an individual not more than $25,520.) Keep in mind that cost-sharing subsidies are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at beWellnm while you are shopping for coverage.
Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Medicaid in New Mexico.
For more information, see Ways to Save Money on Obamacare in New Mexico.
3. If you are unemployed in 2021, you qualify for free health insurance.
If you receive unemployment benefits for at least one week in 2021, the American Rescue Plan guarantees that you can receive a mid-level silver plan for 2021 at no cost to you. This is because the law will disregard any income you earn over 133% of the federal poverty level. And that, in turn, will lock in the highest level of premium assistance for you. If you get a job, your eligibility will change. You’ll be able to apply for this benefit when you purchase an insurance plan through beWellnm. Be prepared to prove that you are receiving or have received unemployment compensation this year.
As an alternative, from April through September of 2021, ARPA provides for 100% free coverage under COBRA for those who have been laid off or subject to a reduction of hours great enough to trigger COBRA eligibility. Speak to your former employer about this benefit; for more information about COBRA, see the U.S. Department of Labor website.
4. If you owed excess premium subsidies for 2020, you don’t have to pay.
Did you expect to owe the IRS for excess health insurance premium subsidies you received last year? The American Rescue Plan Act says you don’t have to pay back the money.
If your subsidy assistance fell short of your eligibility, you can still claim the additional amount owed to you when you file your taxes. But if your subsidy amount was too large, you get a free pass this year—and only this year. In other words, don’t underestimate your income when you purchase a 2021 plan because you hope for a similar break next year.
Because this rule is new and tax season is upon us, you may need to call your tax preparer for help. It’s not yet clear, for example, what you should do if you’ve already filed your 2020 tax return and repaid your excess tax credit. If you’re not sure what to do, you can always request an extension to file your taxes, giving you until October 15 to sort it out.
5. You won’t face a tax penalty for going without health insurance in 2021—but there are big downsides to being uninsured.
Obamacare’s tax penalty went away in 2019. That means that if you didn’t have health insurance coverage in 2020, you won’t have to pay a penalty when you file your taxes this year.
However, even though there's no more tax penalty, think hard about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty would. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)
6. For 2021 in New Mexico, average premium rates decreased slightly and the marketplace picked up one more insurer.
For all plans offered to individuals and families through beWellnm, 2021 health insurance premiums decreased by an average of about 1.5%. Molina and True Health average rates dipped a bit while Blue Cross Blue Shield plans went up an average of 7.6%. Unfortunately, the marketplace lost New Mexico Health Connections, an ACA CO-OP, which closed at the end of 2020. But two new insurers -- Friday Health Plans and Western Sky Community Community Care -- came on board, raising the total number of New Mexico marketplace insurers to five.
7. No Insurers Sell Short-Term Health Insurance Plans in New Mexico.
In 2018, the Trump administration made it easier to purchase short-term insurance plans. These plans don't have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. The federal rules say that short-term plans can last for as long as three years. States can make their own rules, however, and the federal changes have little effect in New Mexico. New Mexico limits short-term health plans to three months and prohibits renewals. It also disqualifies anyone who's had a short-term plan in the past 12 months from buying a new one. Because of these restrictions, no insurers currently sell short-term health insurance plans in New Mexico.
Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in New Mexico.
8. New Mexico will operate its own health insurance exchange beginning in the of Fall 2021.
Though you visit beWellnm to sign up for health insurance, New Mexico actually uses the federal platform, HealthCare.gov, to enroll you. This is scheduled to change for 2022 health insurance signups. Running its own exchange will give New Mexico more flexibility, including the ability to offer state-specific plans or subsidies, as well as enrollment periods that differ from the federal schedule.
9. You can get help signing up if you need it.
A couple of years back, the Trump administration drastically cut funding for programs that provide help with health insurance enrollment. But the Biden administration is expected to quickly reverse that trend, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in New Mexico.
You may also be interested in:
Where to go in New Mexico to get health plans under the Affordable Care Act (Obamacare) and how to get help with the application process.
Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in New Mexico.
Learn the five factors that determine what residents of New Mexico will pay for health insurance under the Affordable Care Act