Policy: Health Care

State health exchange looking at financing options

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News,Business,Health Care

SANTA FE, N.M. (AP) — New Mexico's state-run health insurance exchange wants to hear from the public on how to raise about $24 million annually to pay for operating the online marketplace in the future.

Among the options are fees on private insurance companies selling health care policies in the state.

Dr. J. R. Damron, the chairman of the exchange's governing board, said Thursday that no decision will be made for several months on a plan for financing the exchange starting in 2016.

"We can't go to the state for money. We have to be financially sustainable, and we're on our own," Damron said.

The board is soliciting public comments through the end of the month.

The federal government has provided grants for developing and running exchanges in New Mexico and across the country.

Nearly 35,000 New Mexicans have signed up for insurance plans offered by private insurers through the online marketplace, according to figures through mid-April from the state insurance superintendent's office. In addition to that, about 17,000 individuals signed up for coverage off the exchange, such as dealing directly with insurers and their brokers.

New Mexico has relied on a federally operated online system for enrolling individuals since October. The state-run exchange handled small businesses but will assume the job of individual enrollment this fall.

In developing a long-term financing plan, Damron said, the exchange doesn't want to assess fees in such a way that it causes premiums to soar or discourages insurers from offering health plans.

"We want to be fair in every approach, and that's why we feel we need to just open up the dialogue and get input from the public as well as state legislators, other individuals and of course the insurers as well," Damron said.

Also Thursday, President Barack Obama's administration released state-by-state enrollment figures that showed 32,062 New Mexicans had signed up for health plans through the exchange through April 19.

Aaron Ezekiel, Affordable Care Act implementations projects director for the state insurance regulator, said the federal and state agency enrollment figures come from different sources, but it's unclear why the totals differ. The state collects its enrollment data from insurance companies in New Mexico because the federal government has been slow to share its information with the state-run exchange.

New Mexicans ages 35 to 64 accounted for about 70 percent of enrollment, according to the Obama administration.

Enrolling younger, healthy Americans is considered important for keeping insurance premiums from rising too much in the future. Older adults typically are more costly to serve because they have greater health problems.

Damron said one of the challenges for the state-run exchange is to attract more of the "young invincibles," which is a term for those between 18 and 34 years old who expect to be healthy and go without health insurance.

According to the Obama administration, Hispanics accounted for about 31 percent of the New Mexicans who signed up for insurance through the exchange. That was the second-highest percentage nationally, ranking only behind Texas. However, the government didn't have racial and ethnicity information on all who went through the enrollment process.

New Mexico initially set a target of enrolling about 80,000 people in insurance plans through the exchange, but the state governing board later trimmed that to 40,000 to 50,000.

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

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