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Know Your Health Coverage Options!

Every New Mexican resident qualifies for some form of health coverage, and it is crucial for everyone to maintain quality coverage. The aftermath of the pandemic has left many without coverage and unsure of their options.

First, if your employer offers you affordable health insurance, you are not eligible for most other health coverage programs. However, if your employer does not offer coverage or it is too expensive, start by exploring your options below.

The first thing you should do is use Healthcare.gov’s online screening tool to see what type of coverage you might qualify for. Based on that screening, we recommend contacting the New Mexico Human Services Department, BeWellnm, or the NM Medical Insurance Pool to get help filling out your application. But if you want to sign up on your own, this blog post has some helpful tips.

 

Medicaid

Medicaid is a comprehensive health coverage program that is available to low-income U.S. citizens. If you receive coverage through Medicaid, all costs related to COVID-19 will be covered free of charge. If you were billed for testing or treatment related to COVID-19, you can file a complaint here. Medicaid eligibility is based on your household’s current monthly income, not how much you made in the past or expect to make this year. You qualify for Medicaid if you make less than the monthly income listed on the table below called “TABLE 1: Medicaid Eligibility.” When selecting your family size, include yourself, your spouse, and everyone you claim as a dependent, even if they don’t need coverage. If you have questions about whether or not to include someone when determining your family size, check here.  

 

To see if you qualify for Medicaid, select how many people are in your family at the far left of the table, then see if your monthly income is below the amount listed. If it is, you likely qualify for Medicaid. Even if you don’t qualify for Medicaid, your children might.

If you think you qualify for Medicaid, visit www.yes.state.nm.us 1-855-637-6574 to confirm that you meet the basic program requirements. 

Sign up over the phone: If you want help with your application call or prefer to complete your application over the phone, call 1-855-637-6574. 

Sign up online:Online Application

Fill out the application on paper:Paper Application

Need help? Call customer service at 1-800-283-4465 or visit this webpage.

During the application process, you will be asked to provide information about your household income. The table below shows the type of income information that you will need to share to get covered.

Source: Brookings Institute

Marketplace Coverage through BeWellNM

 Marketplace Coverage is available to individuals and families that do not qualify for Medicaid and are not offered insurance by an employer. Many Marketplace applicants qualify for premium reductions based on income and household size. These reductions are called Premium Tax Credits, and are based on your expected incomefor the year you are applying for coverage. For instance, if you were enrolling for coverage for 2024, you would calculate what you think your income will be for 2024, and the Marketplace will use that amount and your household size to calculate the discounts you qualify for. For questions about how to estimate your income and who to include in your household, click here.

If you lose your job-based health insurance, have a significant reduction in your income, or experience other qualifying events, you may be eligible for a special enrollment period to sign up for coverage. If you experience one of these events, you have a 60-day window to apply for coverage.

Remember, if your income goes up during the year, you should adjust it on bewellnm.com so that you don’t have to pay it back at the end of the year. You can also adjust your income down if you expect to earn less, which will reduce your premiums. If you gain a new form of coverage, such as Medicaid or job-based coverage, make sure to terminate your coverage through BeWellNM to avoid unexpected fees.

 

If you think you qualify for Marketplace Coverage through BeWellNM, you can apply, compare plans, and find resources at bewellnm.com or call 1-833-862-3935.

 

 

The New Mexico Medical Insurance Pool

All people who reside in New Mexico qualify for the New Mexico Medical Insurance Pool (or “the pool”) if they are ineligible for other coverage . You can sign up for the pool any time of the year. You can get premium discounts based on your income. 

Normally, the pool uses your tax return from the previous year as well as any Social Security payments you receive to determine eligibility. However, if you lose your job or have other major changes in your economic situation, you can give them an estimate of your current income and the pool will work with you to reduce your premiums.

If you think you qualify for the New Mexico Medical Insurance Pool, visit nmmip.org or call 1-505-424-7105 or 1-844-728-7896.

Fill out a digital or paper application:Digital or Print Application

 

Keep your employer coverage

COBRA allows you to continue the health coverage you had through your employer after you lose a job, as long as the termination did not involve gross misconduct. This option is available to workers whose employer covers 20 or more employees. COBRA is usually quite expensive and other coverage options, like Medicaid, Marketplace Coverage through BeWellNM, and the NM Medical Insurance Pool, are typically more affordable. Click here to see if you qualify for COBRA. For application assistance, call 1-866-444-3272. If you need more information, you can visit the following websites:

New Mexico COBRA Insurance - Health Care Continuation

U.S. Department of Labor: Continuation of Health Coverage (COBRA)

 How can I get help with my application?

If you want to talk to an enrollment counselor who is not affiliated with any health insurance company, visit https://bewellnm.com/Find-Counselor. They can usually help you sign up for any type of insurance, including Medicaid, Marketplace Coverage through BeWellNM, the NM Medical Insurance Pool, or Medicare.

If you want to talk to a broker about signing up for private insurance or insurance through the NM Medical Insurance Pool, visit https://bewellnm.com/Find-Broker to find a broker in your area.

Medicaid

Human Service Department’s Customer Assistance Center: 1-800-283-4465

Marketplace Coverage through BeWellNM

BeWellNM’s Call Center: 1-833-862-3935

NM Medical Insurance Pool

Office Number: 1-505-424-7105

Call Center: 1-844-728-7896

 

How do I avoid scams?

Unfortunately, some are using this pandemic as an opportunity to sell junk health insurance by misleading people about their options. Here are some websites you can trust to give you accurate information about comprehensive health coverage:

Hsd.state.nm.us or yes.state.nm.us

bewellnm.com

Healthcare.gov

NMMIP.org

 

Health Action

Proposed EIB regs could be a model for US


Thursday, October 14th, 2021 at 12:02AM

Safeguarding public health is central to the mission of the Environmental Improvement Board (EIB), and it has a rare opportunity to protect the long-term health of all New Mexicans with a single action this month. As it considers the New Mexico Environment Department’s (NMED) proposed oil and gas pollution rules, the EIB should resist industry attempts to weaken the regulation and instead include key improvements supported by public health advocates and industry that will deliver the strongest possible protections – especially for frontline communities living closest to well sites.

Gov. Michelle Lujan Grisham has made a commitment to enacting rules to cut ozone and methane pollution that are a model for the nation in protecting public health. NMED has worked long and hard to get here and, with a few key improvements at (a two-week) hearing that (ended Oct. 1), the state can finalize rules that truly lead the nation and protect frontline communities from pollution. The communities we work with are seeing the serious health impacts of oil and gas pollution. (Such) pollution is taking a toll on all New Mexicans’ air, water and health, but rural communities, tribal communities, children and the elderly are especially at risk. The American Lung Association gave New Mexico’s top oil- and gas-producing counties – Lea, Eddy and San Juan – an F grade for ozone in its 2021 State of the Air Report. Oil and gas operations are a significant source of ozone-forming VOCs (volatile organic compounds), as well as methane emissions from venting, flaring and leaks. Well-site toxins can worsen respiratory diseases and trigger asthma attacks, and smog can also worsen emphysema and impact the cardiovascular system. That is why the EIB should strengthen the proposed rules to protect frontline communities by requiring more frequent inspections to find and fix leaks at sites that are in our backyards; accelerate the transition to lower polluting zero-bleed pneumatic controllers; and ensure that pollution created during well completions is captured.

Not only are improvements to the NMED’s proposed rules based on requirements already in place in such leading states as Colorado, but also they are supported by public health, community and environmental leaders across the state, as well as by the National Park Service and even by Oxy USA Inc., one of the top producers in New Mexico’s Permian Basin. This level of broad, diverse support is rare in New Mexico, and it offers the EIB an excellent opportunity to enact nation-leading rules that protect all of us from dangerous oil and gas pollution. More than 130,000 New Mexicans live within a half-mile of oil and gas development, including communities of color that face disproportionate impacts from climate change and air pollution.

Operators such as Oxy understand that reducing emissions is common sense, and good for their bottom line and our air. Colorado has successfully implemented rules, including more frequent inspection schedules for frontline communities, that have led to a drop in leaks and emissions. Now, it’s New Mexico’s turn.

We support Gov. Lujan Grisham and NMED’s efforts to hold the oil and gas industry accountable in reducing ozone and methane pollution. For our health and for our climate, the EIB must strengthen the proposed pollution rules to protect New Mexicans living closest to development.

https://drive.google.com/file/d/1jAZi1Akh0veeleVJ6QlWnSmRtghXkOST/preview

https://drive.google.com/file/d/1bJFoseqRouLodWLVMl2d1GXDw0Tmyiy_/preview

 

Health Action

New Oil and Gas Rules Can Protect Public Health

"The communities we work with are seeing the serious health impacts of oil and gas pollution."

Oil and gas pollution is a public health issue.

The New Mexico Environment Department and the Environmental Improvement Board must strengthen rules to protect those living closest to development. See the op-ed below for more, from The Santa Fe New Mexican:

New oil and gas rules can protect public health

  • Sep 24, 2021, Updated Sep 24, 2021

Safeguarding public health is central to the mission of the Environmental Improvement Board, and it has a rare opportunity to protect the long-term health of New Mexicans with a single action this month.

As it considers the New Mexico Environment Department’s proposed oil and gas pollution rules, the Environmental Improvement Board should include key improvements supported by public health advocates and industry that will deliver the strongest possible protections — especially for frontline communities living closest to well sites...(read more)

 
Health Action

David Mitchell Talks Affordable Prescriptions

"High prices limit access to medications people need right now." (David Mitchell)
 
Access to affordable prescriptions is critical for our communities throughout both New Mexico and the United States.
 
The latest false attack on Medicare negotiations is that proposed legislation will limit our access to prescription drugs. It’s important to set the record straight clearly and directly.
 
 
 
 
 
Health Action

Fact-Checking Pharma

New ad campaigns financed by the pharmaceutical industry are spreading rumors about direct Medicare negotiation — here's why those rumors are false.

Health Action

‘We Just Have To All Agree That This Isn’t Working’: Drug-Pricing Reform Faces ‘Pivotal’ Moment On Capitol Hill

Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.

Yahoo Finance: HHS Ready To Battle Drug Companies For Lower Prices In Court: Sec. Becerra

Drug prices are once again in focus on Capitol Hill as lawmakers renew their push for pricing reform. And U.S. Health and Human Services Department Sec. Xavier Becerra has joined in on the effort. "We just have to all agree that this isn't working. Countries around the world are providing medicine to their people for far less than we do," Becerra told Yahoo Finance in an exclusive interview Monday, adding that often those same drugs are made in the U.S. Becerra made an appearance alongside U.S. Rep. Frank Pallone (D-NJ-06) and U.S. Sen. Cory Booker (D-NJ) in New Jersey Monday at a multi-city event to discuss lower drug costs. (Khemlani, 8/17)

FiercePharma: Buckle Up, Pharma. Your Industry Faces A 'Pivotal' 45 Days In D.C., Analyst Warns 

If there was any doubt about the sincerity President Joe Biden wanted to convey with his appeal to Congress on drug pricing reform, he removed it by bringing his departed mom into the discussion. Speaking in the East Room of the White House on Thursday, Biden recalled that Catherine Biden’s “prescription drugs were so expensive” that it took money from himself, his two brothers and a sister to cover the cost so she wouldn’t have to “exhaust the little savings she had.” With that, Biden set the scene for what promises to be a contentious several weeks in Washington as Congress weighs potential measures to combat high drug costs. (Dunleavy, 8/16)

KVOA: AARP Launches Campaign To Lower Prescription Drug Prices

On Monday, AARP launched a three-week television, and radio advertising campaign urging U.S. Senators to support allowing Medicare to use its power to negotiate drug prices with drug manufacturers. The seven-figure investment highlights negotiation as a critical step toward lowering prescription drug costs for all Americans, especially seniors who on average take between four and five medications each month and have a median income of just over $26,000 a year, AARP said. (Nylander, 8/16)

WREX: New Laws Aim To Lower Prescription Drug Prices In Illinois

Governor JB Pritzker Monday signed a package of legislation that aims to address financial obstacles in accessing health care, while increasing transparency when purchasing prescription medications. HB 119 formalizes the legal process for donating unused prescription drugs to certified pharmacies or health departments. By establishing a prescription drug repository program, prescription and over-the-counter medication that remain unexpired and unopened can be returned to pharmacies and reused for eligible populations. (8/17)

Health Action

We can make drugs more affordable for New Mexicans

  • Aug 14, 2021

It is tough to go even a week without seeing another report about pharmaceutical industry profiteering, and it’s time for New Mexicans to fight back. In the latest outrage, the New York Times reports the drug manufacturer Biogen will charge $56,000 a year for its new Alzheimer’s drug, Aduhelm.

Drug prices have little to do with the cost of research and development and the need to deliver affordable treatment to patients, and much more to do with company revenue targets and profits. Biogen’s stock soared nearly 40 percent on news of the $56,000 price tag. Prescription drug companies are the only businesses in the health care industry whose rates are not regulated. It’s time to hold them to the same standard as all other health care providers.

New Mexico needs a prescription drug affordability board to help ensure we all have access to affordable medications, because drugs don’t work if people can’t afford them, and our health care system cannot sustain the continued upward pressure of rising drug costs. By creating such a board, the state Legislature and Gov. Michelle Lujan Grisham can empower an independent body with the authority to evaluate high-cost drugs and set reasonable rates for consumers.

Other states are already acting to take on the pharmaceutical industry’s anti-consumer practices. The Colorado Legislature just passed a prescription drug board that will consider a broad range of economic factors when setting appropriate payment rates for reviewed drugs, requiring pharmaceutical manufacturers to justify drug costs. Once a fair rate is determined, the board sets an upper payment limit that applies to all purchasers and payer reimbursements in the state, ensuring lower costs benefit consumers.

The bill sets various conditions that would trigger an affordability review, including when prices increase by more than 10 percent per year, or exceed either $30,000 a year for brand-name drugs or $100 a month for generics per person. Patients or consumer advocates also could nominate drugs for review.

New Mexicans continue to struggle to afford the prescription drugs they need, often having to choose between their medication and other necessities, like rent and groceries. Meanwhile, the drug companies that produce these drugs make billions of dollars a year in profits.

The Journal of the American Medical Association reports 35 big drug companies raked in $8.6 billion in profits between 2000 and 2018. Nine of the top 10 companies spend more money on marketing and advertising than they do on researching new drugs. There is no excuse for the high prices they charge.

A new statewide coalition of health experts, patient advocates and consumers — New Mexico Consumers for Affordable Prescriptions — is urging our lawmakers to create a prescription drug affordability board and end the prescription drug price gouging that hurts our families and neighbors. Organizations ranging from AARP, the Center on Law and Poverty, Health Action New Mexico, to New Mexico Voices for Children and the New Mexico Conference of Churches, have come together to demand action in the 2022 legislative session.

On average, Americans pay four times as much for the same medicines as people in other countries. As prescription drug companies continue to increase prices, it’s time to stand up to those who are harming vulnerable New Mexicans. We need controls to make drugs more affordable for people. New Mexico needs a prescription drug affordability board.

Kurt Rager is director of Lutheran Advocacy Ministry, New Mexico, and Erik Lujan is board president of Health Action New Mexico.

Health Action

Reaching the Unvaccinated

As more groups and individuals join the ranks of fully vaccinated,  another ~40% of New Mexicans and ~50% of Americans have reported a myriad of reasons they are hesitant to get vaccinated.

Recently, KOB 4 Eyewitness News gathered information on a research poll conducted by UNM policy professors. This poll featured over 2,000 responses from New Mexicans in regards to how New Mexicans feel about the Covid-19 vaccines. This research suggests that currently, 36% of unvaccinated New Mexicans intend on never getting the shot (that is 10% of everyone 18+ and 8% of the entire state). They found that vaccine hesitancy is extremely high among rural New Mexicans and Native Americans. Hispanics/Latinos and other minorities had a lower than average vaccine hesitancy rate. The study also found that younger people were less concerned about getting the shot as they felt it was unnecessary. 

This study delved into the various reasons many groups face uncertainty about the vaccine. Some things contributing to such hesitancy within New Mexico include, but are not limited to, cultural beliefs, political beliefs (51% of unvaccinated Republicans say they will never get the shot), overall stress about the moment they get the shot (many people prefer to get their jab through a health care professional familiar and trustworthy to them), misinformation in regards to Covid-19 vaccinations (the uninsured can still get the vaccine), and lack of equitable access. 

A crucial takeaway for advocates is that not all unvaccinated individuals are against the vaccine. Two-thirds of the unvaccinated in New Mexico do intend to get the vaccine eventually but are hesitant or lack equitable access. For these individuals, making the vaccine as accessible as possible, mitigating potential hesitancies such as the fear of missing work, as well as education towards the true science behind the vaccine, will be crucial in the effort to increase vaccination rates.

To help combat the significant number of individuals with a lack of vaccine access, Health Action has embarked on a targeted vaccine project to get rural older adults and farmworkers vaccinated. These efforts will include direct and indirect outreach, acting as a liaison between rural communities and state vaccination programs, and burgeoning partnerships with local clinics and trusted messengers to spread the word about how to get the vaccine. 

Only through on-the-ground, grassroots efforts and direct, tailored action can we begin to witness a shift towards trust in the vaccine among the unvaccinated and increased vaccination rates in rural and vulnerable populations. If the vaccine becomes more available and outreach efforts overcome hesitancy, New Mexico can get ahead of Covid-19 and the Delta variant and prevent more loss of life.

Contact gabriella@healthactionnm.org for information about this project.

Written by Katelyn Patchell, Gurleen Sembhi, and Gabriella Rivera

Health Action

Andrew's Testimony on new EPA Methane Rules

Oil and Gas emissions pose an imminent public health threat. During an EPA listening session for the upcoming oil and gas methane rule, we heard from our own Andrew Baker on the need for action to curb emissions from oil and gas. The full transcript of his statement is below.

If you'd like to provide your own public comment, submissions are open until July 30, 2021 at this link.

            Hello, my name is Andrew Baker and I’m a policy analyst with Health Action New Mexico. I’m a recent graduate of the University of New Mexico’s College of Population Health, and I’ve lived in New Mexico since I was 4 years old.

            I would like to thank the Environmental Protection Agency for allowing me to speak at this hearing today as a member of the public. I believe that the proposed methane rule is in the interest of the health of New Mexicans, and I would like to voice my support. Right now, there are over 130,000 New Mexicans living within a mile of an active oil/gas operation, many of whom are traditionally disadvantaged. As a matter of environmental justice, it’s important that we address emissions across all lands, not just areas with a high population density – more than 1 in 3 New Mexicans live in a rural area, so this issue is especially important for my state.

            To demonstrate the effects of oil and gas emissions on our communities, I’d like to share some findings from a Health Impact Assessment conducted last year in Counselor, New Mexico. This assessment found that residents who lived within line-of-sight of an oil and gas operation (more than ten percent of the population) suffered respiratory symptoms after drilling began near their homes, which is consistent with national health studies. While these symptoms can’t all be attributed to methane emission, we know that methane is a precursor to formaldehyde and is found with other volatile organic compounds and emissions from the oil and gas industry that may increase the rates of these symptoms. Beyond those direct health impacts, people are anxious about the lack of information around the safety of their air, and the impacts of oil and gas pollution compound with health impacts of other particulate matter. I’ve grown up dealing with occasionally poor air quality from dust storms and wildfires, and it’s tough to be outside, but I couldn’t imagine dealing with that short-term stress if I had an underlying respiratory condition.

            New Mexicans care deeply about our relationship with the environment – we’re the Land of Enchantment, and there are plenty of cultures that have been here before the USA was a country, that place an emphasis on environmental stewardship. There’s a deep understanding in New Mexico that the health of our environment is closely tied to the health of our people, but our laws have not caught up with that understanding. I’ll often run into people on the trail or on our public lands who have moved here for the climate, because our dry air helps with respiratory issues, because we’ve only got 4 or 5 days without sunshine per year, and because there are so many outdoor areas for recreation, all put at risk by methane emissions. As a young person, I’ve also experienced the generational anxiety around climate change and pollution. I know many people who have seen the lack of action on climate issues and used that to justify pessimism and nihilism. I have friends who have taken direct action to curb their impact on the climate – I’m one of many people who’ve changed their diet and behaviors to lessen our impact, and plenty of my friends try to stay up to date with the latest news about what they can do to improve their impact on the world, but it’s tough to make those personal commitments when the actions of industry are such an overwhelming factor in climate change. It’s heartbreaking to hear my friends say that they don’t believe it’s ethical to have children, but we are seeing significant impacts to our health and our climate from this pattern of oil and gas development, and it’s tough to convince them to be hopeful.

            I had the chance to sit in on a meeting of the New Mexico Environmental Department’s Ozone Attainment Initiative during initial public comment back in 2019, and it was encouraging to see all the engagement on such an important environmental issue, but there were plenty of points in the meeting where members of the public had questions about the environmental impacts of oil and gas, or methane more specifically – and the line they were given was that the rules didn’t allow for measurement of methane directly, but that ozone could be used as a proxy. More recently, we’ve seen that some of the worst polluters in the country have used the opacity around those rules to self-report their methane emissions and downplay the severity of the harm to the climate and to our health at all levels. I’m hopeful that this rule can capitalize on that engagement and allow local advocates to learn more about what’s in their air and how it affects their health.

            Finally, I’d like to urge this committee to look at some additional actions that can improve the health of our communities. That Counselor study found that residents often did not receive information on projected exposure, or times when emissions would be at their peak. That information is vital for people to make decisions about their health – the dose makes the poison, and if people can take actions to lower their exposure, we should give them the tools to do so. I can see a dust storm and stay inside, but we need special cameras to detect the presence of oil and gas emissions. It’s also important that we have more transparency around emissions compliance – during our last state legislative session we gave our environmental improvement board the authority to deny permits to producers who have not complied with regulations, but this information is often tough to find and not standardized. This is to underline that while state action is possible, we need strong federal actions, and really action at all levels to support this goal.

            Again, I’d like to thank the EPA for addressing this critical issue. Increased commitment to methane emissions is important for the health the environment and all people, but especially for New Mexico and our historically underrepresented communities. New Mexicans have been begging for action, and I hope that this rule is a first step in a comprehensive process to protect our health and our environment.

Health Action

It's Simple: Medications Don't Work if People Can't Afford Them

At Health Action NM, we've partnered with the New Mexico Coalition for Affordable Prescriptions, NMCAP, to advocate for the creation of a Prescription Drug Affordability Board to help ensure that New Mexicans can count on affordable medications. Here, Albuquerque resident Jeanne Hamrick explains how out-of-pocket expenses for her medication have impacted her life. With so many New Mexicans experiencing serious hardships due to the cost of their essential prescriptions, there has never been a better time for drug pricing reform.

Jeanne has Multiple Sclerosis and is struggling to pay the prescription costs for her essential medication. Watch the full story below.

https://www.youtube.com/watch?v=y9EbTPl6pQo

 

Health Action

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