The Marketplace is live! Visit the NM Health Insurance Exchange (NMHIX) website at:
What is the health insurance marketplace? How does it fit into the ACA?
The health insurance marketplace (often called the “exchange”) is a new way to choose health insurance. One way to picture this is like a big, online farmer’s market or mercado, where each booth is offering a different health insurance plan. Or picture a website like Priceline or Expedia - only instead of comparing flights and rental cars, you will be comparing health insurance plans. The same information will also be available in paper form, for those who can’t or don’t want to use a website.
All health insurance plans on the marketplace will be comprehensive, meaning that they will cover a wide range of services including doctor’s visits, hospital stays, and prescriptions. The marketplace is designed particularly to help individuals who do not get insurance through their employer, and small business owners who wish to offer health insurance for their staff.
Open enrollment for the Health Insurance Marketplace starts October 1, 2013.
[Is it possible to put some sort of auto-update countdown widget on here, so that each day there is an updated number of days left? Similar to this, but whatever you think looks/works best: http://www.timeanddate.com/clocks/freecountdown.html]
The Kaiser Family Foundation is keeping track of national events regarding the Health Insurance Marketplace (“Exchange”) here.
How does it affect me? Who qualifies?
The Health Insurance Marketplace is designed for people who make too much money to qualify for Medicaid, but not enough to be able to afford purchase private insurance at the current prices.
- You are eligible if:
- You are living in the U.S.
- You a U.S. citizen or national (or lawfully present), AND
- You are not currently incarcerated
(Source from HealthCare.gov.
- The Marketplace might be a good option for you if:
- You do not qualify for Medicaid. This means you are above 138% of the Federal Poverty Level, which was $15,415 for a single person in 2012.
- You are self-employed.
- You are a small business owner who wants to offer good health insurance to your employees.
- You do not have health insurance for some other reason.
I want in. What do I do next?
- The details of New Mexico’s Health Insurance Marketplace are still being smoothed out. The Marketplace is supposed to be open for October 1, 2013, and there is still a lot of work to do between now and then. Here is a partial list of what needs to be done between now and October 1st in order to have a functioning Marketplace:
- Appoint a board of directors
- The board must meet to make key decisions about hiring staff, choosing an IT vendor, etc.
- Contract with an IT group; design, make & launch a new website and information system to house the Marketplace
- Plan how the Marketplace will work for non-digital populations - who will help people understand and choose their plans?
- Select the plans that will be offered on the exchange
(Last updated 4/25/2013.)
The No Wrong Door policy is designed to make your application process much easier to complete. Under the ACA it is anticipated that you can go to one place to see if you qualify for Medicaid OR the Exchange - you shouldn’t have to go to different places to see what you qualify for. We are still waiting to see how this will play out in New Mexico.
What’s the difference? State-based, Federal, & partnership exchanges
The health insurance marketplace is a requirement under the Affordable Care Act. However, states get to choose whether they want to (a) run it on their own, (b) have the federal government run it for them, or (c) partner together with the federal government. New Mexico’s Governor Susana Martinez selected the first option, called a “state-based” marketplace. This means that New Mexico is responsible for creating and running the new health insurance marketplace in our state.
The federal government gave New Mexico conditional approval to run its own marketplace on January 3, 2013. If New Mexico meets the deadlines set in this letter, it will continue to run its own marketplace. If New Mexico does not meet these deadlines, the federal government may step in to create either a federally-facilitated or a partnership marketplace, which are options (b) and (c) above.