Making Insurance Affordable

While the Affordable Care Act greatly expanded health insurance options, it has only been the first step for many working families. Less than 50,000 people have signed up for the Health Insurance Exchange in New Mexico, and the number one reason cited for not getting coverage is the cost. Even with federal subsidies to help people pay for insurance, many low-income families are finding the price is still out of reach.

For example, a single working mother in New Mexico who earns $12 an hour does not qualify for Medicaid because her income is too high. Yet, her income barely allows her to meet household expenses of rent, food, childcare, transportation, and other basic costs. To get health insurance on the Exchange would likely cost over $90 per month for a Silver-level plan. Moreover, the out-of-pocket costs for deductibles and co-pays under this plan could be over $3,000 per year.

The Center has been working to identify and support options to address the healthcare affordability gap, which is primarily affecting working parents and adults with incomes between 138% and 200% of the federal poverty level (FPL). Even people who have enrolled in insurance are struggling to meet deductibles and co-pays, and are being sent to collections because they are unable to pay these costs. Some options that New Mexico could pursue to minimize this problem include: adopting a “Basic Health Program,” which would primarily be paid by the federal government; providing state subsidies to help people purchase coverage on the Exchange; or expanding Medicaid to cover individuals up to 200% FPL. If the state does not act soon, tens of thousands of New Mexicans will remain uninsured and will continue to rely on county and hospital indigent programs that are already fragmented and unable to provide a full range of services.

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