In New Mexico, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2022 coverage.
This website provides information 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 may be able to use a special enrollment period to get covered.
In New Mexico, open enrollment for 2022 Affordable Care Act (Obamacare) coverage has ended. This means that, unless you qualify for an exception or your income is low enough for Medicaid, you won't be able to get health insurance through beWellnm until open enrollment for 2023 begins next fall.
If you’ve lost your job or significant income in the past 60 days, whether due to the COVID-19 pandemic or for any other reason, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current plan outside the open enrollment window.
In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Missed the New Mexico Obamacare Enrollment Deadline?
2. You may qualify for new Affordable Care Act subsidies.
Last year, President Biden signed the American Rescue Plan Act (ARPA). The law provides $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis. The relief measures include additional premium subsidies for those who purchase health insurance through beWellnm. People who apply for 2022 coverage under a special enrollment period can access these subsidies. (Under the Inflation Reduction Act, the additional subsidies are set to expire at the end of 2025.)
Federal tax credits. Until the passage of ARPA, the ACA provided premium subsidies only to 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 used to be $111,000. For an individual, it was $54,360.
At least through 2022, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from beWellnm. Technically, 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.
Cost-sharing subsidies. More than half of the people who purchase coverage through beWellnm receive assistance in the form of cost-sharing reductions (CSRs). CSRs 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 2022 health plans, that means a family of four in New Mexico can't earn more than $69,375 and an individual not more than $33,975.) But they are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at beWellnm while shopping for coverage.
Medicaid. You may qualify for free or low-cost coverage through Medicaid in New Mexico if your income is very low.
For more information, see Ways to Save Money on Obamacare in New Mexico.
4. 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 don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, 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.)
5. New Mexico is now operating its own health care exchange.
For 2022 health insurance signups, beWellnm will separate from the federal platform, HealthCare.gov, to run its marketplace. 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.
6. For 2022 in New Mexico, average premium increased but new subsidies were available to cover the difference for most people.
For all plans offered to individuals and families through beWellnm, 2022 health insurance premiums increased at an average rate of about 15.5%. These approved increases are some of the steepest in the country, driven mostly by Molina's approved average increase of a whopping 25.6%. True Health has also been approved for double-digit increases. Costs for plans from other carriers -- Blue Cross Blue Shield of New Mexico, Friday Health Plans, Western Sky Community Care (Ambetter/Centene), and Presbyterian Health Plan -- are expected to rise much less or even decrease. The best news in all of this is that, because of the new subsidies available for 2022, coverage should be more affordable, not less, for most New Mexicans.
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. However, states can make their own rules, 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. You can get help signing up if you need it.
The Biden administration is greatly increasing enrollment assistance plans, 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.