New Mexico moves ahead with health exchange

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SANTA FE, N.M. (AP) — Gov. Susana Martinez's administration is moving ahead to establish a state-run clearinghouse to help small businesses and tens of thousands of individuals find affordable health insurance they currently lack.

A fight over the exchange, however, could break out in next year's Legislature.

Attorney General Gary King's office is reviewing whether new legislation is needed to implement a health insurance exchange or whether it can be done as the Republican governor plans, without a change in current law or legislative involvement.

The exchange is envisioned as an online shopping center for the uninsured to buy health coverage from a selection of plans offered by insurance companies with benefits tailored to New Mexico. It's to be ready to enroll people starting next October and under federal law must be fully operating by January 2014. That year, an estimated 55,000 New Mexicans may use it to enroll in an insurance plan.

Some states waited for the outcome of the presidential election to make a decision, but New Mexico has been working since last year on an exchange plan.

"Overall, we never really wavered from the idea that it needs to be a state exchange," Human Services Secretary Sidonie Squier said in an interview Tuesday.

Under a 2010 law championed by President Barack Obama to expand health care coverage, states can run an exchange, leave that task to the federal government or partner with federal health officials.

"We wanted to build something that we think is unique to New Mexico and works for New Mexico," said Squier.

A fifth of the state's population lacks health care, and it's estimated as many as 250,000 New Mexicans may become eligible to buy health insurance through the exchange between 2014 and 2020.

Under the federal law, uninsured individuals and families can receive subsidies to reduce the amount they pay for insurance. Small businesses can be eligible for a tax credit to help provide medical coverage for workers.

Martinez doesn't plan to establish a new agency to run the exchange. Instead, the exchange will be operated by the New Mexico Health Insurance Alliance, a nonprofit public corporation established in 1994 to provide access to insurance for small businesses and some individuals. The alliance is funded by an assessment on insurance companies.

The state received a $34 million federal grant for an exchange, with almost $24 million earmarked for a computer system that will be used by uninsured New Mexicans to shop for health plans in the marketplace. The alliance plans to award a contract for the computer system in early January.

Squier said the administration doesn't believe legislation is necessary to implement the exchange because it can be handled through the alliance.

However, the attorney general's office is reviewing whether the Legislature must authorize an exchange and approve changes in law for the alliance to operate it.

"We do have some serious concerns," Phil Sisneros, a spokesman for King, said Wednesday.

Martinez vetoed an exchange proposal approved by the Democratic-controlled Legislature last year. She said the measure was premature.

Sen. Dede Feldman, an Albuquerque Democrat, said the alliance's governing board needs more consumer and employee representation rather than being tilted in favor of the insurance industry. There also are questions whether the alliance's current mission focuses on a much narrower segment of uninsured individuals than the exchange must handle.

Most of the alliance's board is appointed by the governor. House Republican Leader Tom Taylor of Farmington said Martinez can fix any problems by selecting more consumer representatives for the board.

"I think we're in fine shape," said Taylor.

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Follow Barry Massey on Twitter at https://twitter.com/bmasseyAP

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