ALBUQUERQUE – The number of New Mexicans without health insurance has been steadily dropping, but officials with the state health insurance exchange told lawmakers Wednesday that cultural and geographic barriers are standing in the way of reaching those who have yet to enroll for coverage.
Officials estimate more than 230,000 people in the state remain uninsured. While nearly half of them are low-income and eligible for health care under the Medicaid program, some 30,000 people could benefit from shopping for insurance through the exchange.
Exchange CEO Amy Dowd said that when it comes to enrollment, New Mexico is on par with other states that have expanded Medicaid.
“The difference with New Mexico, it’s more difficult here,” she said. “We are a border state, we have a large number of the population that’s ineligible to even purchase on the exchange, and it is expensive to reach the frontier, the rural populations. We have unique challenges.”
Testifying before the Legislative Health and Human Services Committee in Santa Fe, Dowd said the exchange has been cleared by federal officials to shift some of the grant money it receives for operations to focus on more outreach.
The exchange intends to target Hispanics and Native Americans as well as rural communities.
Some 44,000 people are currently enrolled in coverage through the exchange, and officials are hoping to boost that number during the current enrollment period, which runs through January.
The exchange has been criticized in recent weeks after legislative analysts released a report that found marketing has been costly and enrollment has been low. Exchange officials on Wednesday challenged the accuracy of the report.
The analysts recommended that the exchange be audited regularly by the state and that restructuring might be necessary to reduce its $15 million annual operating budget if enrollment remains low.
Michelle Aubel, a program evaluator with the Legislative Finance Committee, told lawmakers there are fees the exchange will have to pay for leasing the federal government’s IT platform for enrolling people. That’s estimated to cost $5 million starting in 2017.
The exchange uses no state general funds. It relies on assessments from insurers that are based on their share of the market in the state. If the assessments increase, Aubel said, insurers will pass that on to customers in the form of higher premiums.
“The higher the operating budget of the exchange, the more that will have to be funneled down to New Mexicans,” she said.
Exchange officials described the operation as lean and efficient. They also argued that a majority of the population targeted by the exchange have been reached in just the first two years of operation.
Sen. Jerry Ortiz y Piño, D-Albuquerque, said he doesn’t believe the problem is with the exchange but rather with federal laws that mandate insurance and the cultural shift needed to get more people to participate.
“The dollars and cents of it don’t make sense,” he said, pointing to the annual cost of paying premiums compared to the penalties people soon will have to pay for not being insured.