Short Term Health Insurance In New Mexico

New Mexico relies on the federal standard for determining the acceptable length of short term health insurance plans. The limit for these plans is currently set at 90 days. This three-month limit went into effect at the beginning of 2017 after a final rule issued by the Obama administration.

Under the Trump administration, the Centers for Medicare and Medicaid Services has issued a proposed rule that would involve extending this limit. If the proposal goes through, New Mexicans and many other Americans will be allowed to hold short term health insurance plans for up to 364 days at a time.

The Health Policy Center of the Urban Institute has estimated that this policy change might draw 11,000 New Mexico residents away from plans that operate in accordance with the standards of the Affordable Care Act. This represents about 21.6 percent of the 51,000 New Mexico residents who currently have individual ACA-compliant health plans.

New Mexico Senators Tom Udall and Martin Heinrich have spoken out against this expansion plan. They worry that relying on these plans for long-term coverage will leave people without enough protection to help with their basic medical needs. The senators believe that federal and state officials can work together to find other ways to help people access reasonably priced health insurance.

New Mexico’s Office of Superintendent of Insurance has also commented on the proposed rule. The state’s insurance commissioner is not opposed to the proposal in the same way that the senators are. The department does have some reservations about residents using short term plans as full healthcare coverage, but the state’s comments noted that the Trump administration’s proposal would allow individual states to make their own decisions about temporary health insurance plans. If the federal limit is set at 364 days, each state can set its own more restrictive rule if desired.

Short term health insurers can choose which health benefits they want their plans to cover. ACA-compliant plans must provide minimum essential coverage, which means that they must include provisions for 10 essential health benefits. These are not required of short term health insurance plans. Temporary health insurance is usually available at a lower price than regular insurance plans as a result.

In 2018, the Kaiser Family Foundation was able to find one short term health insurance plan available for purchase in Albuquerque, New Mexico. That plan didn’t cover maternity care, substance abuse treatment, mental health services or prescription drugs. These types of care would be covered under any ACA-compliant health insurance plan.

Limiting the risk pool to only healthy people is another way that insurance companies keep premiums low. Short term insurance plans are medically underwritten, so you must answer health questions when applying. If you don’t meet an insurance company’s underwriting standards, you probably won’t be approved for a plan. Even if you currently have a short term health plan, a change in your health status may make it impossible for you to take out another one in the future.

Pre-existing conditions don’t always make you uninsurable. However, if the short term insurance company does choose to issue you a policy, there’s a good chance that the policy will include a rider that excludes coverage for claims related to your health history.

Carriers Offering Short Term Policies in New Mexico

National General Accident and Health

BlueCross BlueShield of New Mexico

Sources:

http://chirblog.org/stakeholders-respond-to-proposed-short term-rules-state-dois-marketplaces/
http://www.santafenewmexican.com/news/short term-plans-called-lifeline/article_1fb4e1c6-f713-5aed-81e4-55894adc6c68.html
https://www.tomudall.senate.gov/news/press-releases/udall-heinrich-call-on-trump-administration-to-halt-expansion-of-junk-health-insurance-plans
https://www.urban.org/sites/default/files/publication/96781/2001727_0.pdf
https://www.kff.org/health-reform/issue-brief/understanding-short- term-limited-duration-health-insurance/