A Victory in Vermont is a Victory for All
Vermont establishes the practice of dental therapists, increases access to dental care for all Vermonters.
It took nine hundred community members and forty state organizations. It took the stories of the people and the facts that backed up their experience. It took the hard work of activists like Voices for Vermont Children. But it happened!
We are so pleased to announce that this week, Vermont Governor Peter Shumlin signed a law that establishes the practice of dental therapists in Vermont. Vermont’s decision to authorize dental therapists is monumental step forward in this mission to make dental care more accessible.
As we rally New Mexico residents and we urge our lawmakers to consider dental therapy as a cost-effective, scalable approach to making the dental care system work better for patients, we are thrilled to be able to point to this recent victory in Vermont.
This innovative, team-based approach enables dental practices to increase the number of people they can serve, is cost-efficient and patient-focused.
In the past year alone, close to a dozen states and tribes, including New Mexico, have pursued establishing these health care professionals as a way to solve deep oral health disparities and severe unmet dental needs. Dental therapists currently practice in Minnesota and on tribal land in Alaska and Washington. They are authorized to practice in Maine and will soon be practicing in Oregon under a statewide pilot program.
And this is just the beginning! The momentum is building, and the need in New Mexico is real. Over half of all New Mexicans have advanced dental disease. One-in-three 3rd graders sit in class with untreated dental disease. And 1.3 million people live in counties that are recognized as having insufficient access to dental care. It’s time to work together to find a way to end this epidemic. It’s time to make dental therapists part of the dental care team.
We know that the victory in Vermont is a step in the right direction for our nation, and this victory provides an opportunity to continue to push for increased access to high-quality dental care in New Mexico. Just last year, the NM Dental Hygienists Association Health Action NM and the reached an agreement with the NM Dental Association to advance common ground legislation to make dental therapists part of the New Mexico dental care team. The legislation will be filed during the 2017 legislative session. We hope state leaders will rise to the occasion and make New Mexico the next state to bring high quality dental care to more of our people.
Join Health Action New Mexico as we applaud Vermont’s progress and join us as we make access to dental care a priority in New Mexico.Word of Mouth
December 1st is Giving Tuesday – a campaign to create a national day of giving at the start of the annual holiday season. It celebrates and encourages charitable activities that support non-profit organizations like Health Action New Mexico.
Today we invite you to pause and consider supporting Health Action New Mexico on the kickoff of Giving Tuesday as we work to increase access to oral health care and connect our New Mexico families to affordable to health care.
Please support Health Action New Mexico. Our goal is to raise additional funding for consumer outreach to the hardest to reach communities-including families in New Mexico’s border region. We make sure consumers, their concerns and needs are at the table in campaigns like the consumer-led movement to expand access and affordability of dental care and expanding health coverage to all people in New Mexico.
With your help we know we can get there. Please share this link via email or on you social media with the hash tag #GivingTuesday to spread the word about this wonderful day and our important work to increase access to affordable health are.
Best wishes during this holiday season,
Health Action New Mexico
After a key market stabilization payments came in lower than expected, non-profit health insurance co-ops around the nation began to close shop. Fortunately for New Mexico, our co-op, New Mexico Health Connections (NMHC), remains financially solvent and is considered to be one of the strongest health insurance co-ops in the nation. In fact, its financial solvency is four times higher than is required by the state’s insurance department.
NMHC’s role is especially important this year, as Blue Cross Blue Shield exits the market. The co-op is building its network of providers rapidly to ensure that consumers can retain their doctors during this transition. Nearly 7,750 providers now accept the carrier’s insurance and the number is growing every day. According to the co-op, providers are coming to them and asking to be contracted so they can continue to see their patients. This is a positive development for the state and will hopefully lead to savings for consumers.
Due to a filing error, NMHC’s plans will not be featured on beWellnm until November 15th. The plans can be viewed here in the meantime. Because of this error, many news outlets incorrectly reported that premiums rose by 26% in New Mexico. The Office of the Superintendent of Insurance has corrected this error and noted that plans have only risen by 7.5%.
Note: Health Action NM does not endorse any insurance carrier or their products. This should not be interpreted as an endorsement of NMHC and is only intended to inform consumers about the state's co-op in light of recent national trends.Health Action
The open enrollment period for purchasing individual or family coverage through BeWellNM has arrived! Beginning November 1, 2015 www.bewellnm.com will be open for those seeking health coverage. The enrollment period is only three months long, ending January 31, 2016. Here are some important things to keep in mind if you intend to purchase or renew coverage:
Before shopping on the exchange, see if you are eligible for Medicaid
You can visit https://www.yes.state.nm.us to sign up for Medicaid. Be sure to seek out free enrollment assistance if you want help with your application by calling Health Action New Mexico at (505) 322-2152.
Medicaid is a health coverage program that provides cost-free insurance to low income Americans. Individuals making less than about $16,105 a year and families of four making less than about $32,913 a year are eligible for Medicaid. Medicaid is available throughout the year, unlike plans acquired on the exchange, which can only be purchased during the open enrollment period. If you are 1) between the ages 19-64 and 2) are a U.S. citizen or lawfully present immigrant and meet household income requirements, you may be eligible for free health insurance.
You can also use the chart below to see whether you and your family qualify for Medicaid:
Health Coverage and Financial Help
If you don’t qualify for Medicaid, the next step is to visit http://www.bewellnm.com, where you can shop for health coverage. It is important to keep in mind that the window for obtaining coverage through the exchange is limited, lasting from November 1, 2015 to January 31, 2016.
You may be eligible for financial help. You will need to know your household income to determine your eligibility. Check out the Get Covered subsidy calculator to see how much you can save on your health plan. Right now, you can view price estimates for plans that you can purchase that factor in tax credits at https://www.healthcare.gov/see-plans/. Insurance lingo can often be confusing. If you run in to any terminology that you are unfamiliar with, check out beWellNM’s health care glossary. You can always call Health Action NM’s office if you have any questions.
Shopping for insurance can be a daunting task. Luckily there are experts available to help you find the plan that is right for you. Health Action New Mexico can connect you to a trusted local assister near you. Click here or call our office at (505) 322-2152 and we will help you arrange a free appointment. BeWellnm is setting up enrollment sites throughout the state. Right now, you can visit the Enrollment Assistance Center at 2301 San Pedro NE near Indian School in Albuquerque. Check back on this post for updates on enrollment sites in other parts of the state.
Shop around before renewing your health plan
If you purchased a plan on the exchange last year then you will be re-enrolled in to the same plan for 2015 unless your insurance company stops offering your plan or you choose to purchase a new plan. If you like the coverage you received you should still be sure to review your plan before renewing it, as the premiums, co-pays, and other aspects of your plan’s cost may have changed. In other words, you may pay more than you did last year for the same plan, so be sure to review your plan and shop around. There may also be new plans offered on beWellnm that are more affordable or better suit you and your family’s needs.
Sign up by December 15th if you want your coverage to start January 1st
While the enrollment period lasts through February 15th, you can start using your coverage at the beginning of 2015 if you sign up by December 15th. If you wait until the end of the enrollment period to sign up for coverage, your insurance will kick in on March 1st, 2016.
The penalty for lacking insurance is higher than it was last year
If you don’t obtain some form of health coverage, you may have to pay a shared responsibility fee. The penalty was the greater of $325 per adult or 2% of income in 2015. This year the penalty has increased to the greater of $695 per adult or 2.5% of income. You can avoid the penalty by enrolling in health coverage.
A hardship exemption exists for those who truly cannot afford insurance. To see if you qualify for a hardship exemption, visit https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.Health Action
Finding a health insurance plan that’s right for you and your family is now easier and more affordable. Starting November 1, people all over New Mexico can sign up for coverage on beWellnm.com.
BeWellNM is a health insurance marketplace that offers:
- financial help to reduce monthly premiums and the cost of seeing your doctor;
- free enrollment assistance;
- shopping tools that make it easy to find the right plan; and
- robust competition to drive down premiums.
Anyone who is currently uninsured or previously enrolled in a plan through the marketplace should visit beWellnm to check out their options. Plans and prices change every year, so you should shop around and make sure you’re finding the one that’s right for you. Here is what you need to know about the beWellnm marketplace.
Protect yourself from the Unexpected
An accident or injury can happen any day. When it does, the last thing you should have to worry about is how to pay for your health care or taking on medical debt. On beWellnm, you can find a plan that keeps you covered, no matter what life throws at you. All beWellnm plans cover doctor visits, hospital stays, prescriptions, preventive care and more.
Financial Help is Available
BeWellnm.com is the only place where you can get financial help to reduce the cost of coverage. Nearly three out of four New Mexicans enrolled in plans on beWellnm currently receive tax credits averaging $196 per month. That would be like completely eliminating your phone bill!
You may also be eligible for financial help to reduce your out-of-pocket expenses.
Even if you’re already enrolled, you should check out your options to make sure you’re taking advantage of the financial help that is available and getting the best deal possible.
Free Enrollment Assistance
BeWellNM.com offers free enrollment assistance to answer your questions and help walk you through the enrollment process. To connect with an enrollment assister in your area, call Health Action New Mexico at (505) 322-2152.
Transparent Shopping Tools
Tools on beWellnm make the enrollment experience much easier for consumers. The website calculates your tax credits and cost sharing reductions for you, allows you to compare plans side-by-side, features a map and list of providers who accept your insurance, and much more. This type of transparency gives you the peace of mind from knowing that you made a smart choice and isn’t often available through other health insurance websites.
More Competition = Lower Prices
A recent study found that plans sold on beWellnm and similar marketplaces in other states are more affordable for consumers, even without financial help. BeWellNM has some of the lowest premiums in the nation and with tax credits those premiums are even lower. That’s why, come November 1, beWellnm.com is the place to shop for affordable health coverage!
Want to know more? Over the next several weeks, Health Action New Mexico will be posting blogs that provide you with everything you need to know about the marketplace including real stories from consumers that received coverage through beWellnm. Stay tuned!
Thanks to all who made Health Action New Mexico’s 20th Anniversary such a special occasion. It was such a joy to see the advocacy community together in one place to celebrate the spirit of the work we all do. We would like to thank AARP of New Mexico, Delta Consulting, New Mexico Health Connections, and Presbyterian Health Plan for sponsoring the event.
Congratulations from US Senator Tom Udall
Video Message from Retired US Senator Jeff Bingaman
The Next Step in Health Reform
The expansion of health coverage has been nothing short of remarkable. Nearly 300,000 people have gained access to health coverage as a result of the Affordable Care Act. As we help newly insured consumers navigate the health care system and use their coverage we must also turn our sights towards the quality of health care in New Mexico.
The New Mexico Department of Health and New Mexico Human Services Department have undertaken the enormous task of developing a strategy to achieve better health outcomes by innovating our health care delivery system. Health Action New Mexico is garnering consumer input on the current draft of the state’s plan, which includes reforming how we pay doctors to incentivize keeping patients healthy, addressing the social determinants of health, and integrating behavioral and oral health in to primary care, among many other initiatives. Health Action New Mexico looks forward to contributing to this monumental step towards a more patient and consumer oriented health care system.
Consumer Alerts: Open Enrollment Begins November 1st
The next window of time to purchase health coverage is just around the corner! On November 1st, 2015 beWellNM.com will be open for shopping. The open enrollment period ends on January 31st, 2016. Advocates should take a look at Health Action New Mexico’s Private Market Enrollment Report to see the state of enrollment in our state.
Here are 5 things for consumers to keep in mind:
1) If you currently have a marketplace plan, it will remain active until the end of the year.
2) If you want your new coverage to kick in by January 1st, 2016 you need to sign up by December 15th, 2015.
4) Even if you like your current plan, you should shop around to see if there is a more affordable plan or a plan that better meets your needs.
5) The shared responsibility penalty for lacking coverage in 2016 raises to the higher of $695 per person or 2.5% of income but the best reason to get covered is to keep you and your family healthy.
Blue Cross Blue Shield dropped out of the exchange for 2016 and New Mexico Health Connections dropped several plans. If your 2015 plan is no longer available, the Office of the Superintendent of Insurance (OSI) is mobilizing a statewide roadshow to help consumers find plans that work for them. Click here to see when they will be in a town near you.
Dental Therapist Task Force
On October 2nd, Health Action New Mexico staff participated in the third in a series of four meetings in which the New Mexico Dental Hygienist Association panel, that includes Health Action New Mexico, and legislators, will again meet the New Mexico Dental Association panel with hopes of coming together to draft meaningful, effective dental therapist legislation for New Mexico. It is not clear whether consensus will be achieved. Dental therapist supporters including dentists, hygienists, educators and community leaders have observed the task force meetings and are invited to attend the fourth meeting. The date for the next task force meeting is yet to be determined and will be later this month or in early November.
From the Field
Victor Montoya and Joe Martinez are working in the Colonias and border areas to help people in those communities engage their neighbors in getting covered and finding ways to access care. “Without accessible health care coverage and services only prisons and poverty will flourish in the Colonias of New Mexico,” Last month, the outreach team also worked with our board president Erik Lujan to train advocates, nurses, and state employees in northern New Mexico on how to enroll individuals in Medicaid and the exchange.
Nohemy Bojorquez-Flores is gearing up for the open enrollment period and gathering stories from her community. “Open enrollment is just around the corner,” says Nohemy. “I am reaching out to the community and keeping them informed!”
On October 15th and 16th from 9 AM to 5 PM, Health Action New Mexico hosted a free outreach workshop on health coverage with Enroll America at the Friends Meeting House. An incredible group of advocates came together to craft our strategy for the upcoming open enrollment period.Health Action
Rate Review: Ensuring Affordability through Accountability
For decades, health insurance premiums skyrocketed alongside insurance industry profits. Left without a way to challenge these arbitrary hikes, consumers were stuck with larger bills without seeing improvements to their coverage. But, recently, state and national health reform initiatives have placed more power in the hands of consumers, creating new tools to hold insurance companies accountable. Rate review is one of those tools.
What is rate review?
Rate review is a process that requires insurance companies to open their books to ensure that they provide “accurate, verifiable data and realistic projections of health costs,” according to the nonpartisan Kaiser Family Foundation. Health Action New Mexico and our partner organizations worked to establish a rate review process to protect consumers and hold insurance companies accountable for unfair health care premium rate increases. The state enacted legislation on rate review in 2011. Now insurance companies have to justify rates with data and the state has to make these proposed increases public. Rate review works because it brings consumers into a process that was once conducted behind closed doors. It uses accountability to ensure affordability.
How does rate review work?
Insurance carriers must submit proposed rate increases to the New Mexico Office of the Superintendent of Insurance (OSI). OSI posts those rates on its website, where consumers can submit comments on the increases. Formal hearings can then be brought forth by consumers. Once OSI has heard from consumers and insurance carriers, it looks at each company’s financial data to determine whether the requests are valid. If a proposed rate is found to be backed by the evidence, the carrier must alter its proposal to an acceptable rate that matches the available data within 30 days.
How has rate review affected premiums?
In many states, final rates are lower than proposed rates thanks to the rate review process. Kaiser Family Foundation recently found that rate review brought down overall rates across the state. Looking specifically at Albuquerque’s benchmark plan, the process directly reduced an increase in rates from 11 percent to 7 percent, saving money for consumers.
What’s the story with Blue Cross Blue Shield?
In June of 2015, Blue Cross Blue Shield (BCBS) of New Mexico proposed a whopping 51 percent rate increase. The request stunned consumers, the media, OSI - just about everybody. BCBS claimed that their customers required more expensive care than those enrolled in plans with other carriers. However, after carefully reviewing consumer feedback and BCBS’s financial information, OSI determined that the rate hike was far beyond justification.
The rates that BCBS chose to submit weren’t supported by the data the company provided. While OSI supported an increase of 24 percent – the highest among all carriers in the marketplace – BCBS refused to cooperate and, instead, dropped out of the market for 2016. This means thousands of consumers will need to find new coverage options in the health care marketplace. Fortunately, other insurance carriers are working to expand their networks to cover providers throughout the state.
What should I do if my BCBS plan is no longer available?
The first thing to keep in mind is that your current plan will remain active until January 1st, 2016. You have between November 1st and December 15th to sign up for a new plan that kicks in on January 1st. Four other insurance carriers offer plans on BeWellNM: New Mexico Health Connections, Molina, Presbyterian, and Christus St. Vincent. There will be 35 plans to choose from on BeWellNM, which is the only marketplace where financial help is available. OSI is also mobilizing a consumer roadshow to help those affected by BCBS’s exit from the marketplace. Click here to see when they are in a town near you.
BCBS does have a plan available but it will not be sold on BeWellNM and financial help will not be available. It is also a “Bronze” plan, meaning that it offers weak coverage with high out-of-pocket costs. Consumers should shop around on the exchange to find a plan that best meets their needs.
How can I get involved in rate review?
The next rate review process begins in the summer of 2016, when insurance carriers propose rates for 2017. Health Action New Mexico will be actively ensuring that consumers are representated as OSI considers the new rates. Submit your story to email@example.com if you think your premiums are being unfairly raised. Also be sure to submit comments to OSI next summer on this page. If you would like to request a hearing, call Health Action New Mexico and we will discuss the arrangements that need to be made to do so. Our number is (505) 322-2152.Health Action
New Mexico Study: Working Individuals Make Up the Largest Group Who Benefit from Medicaid Expansion
Study Estimates that 56 Percent of those benefiting from New Mexico’s Medicaid Expansion are Working Adults in Key Economic Sectors
More than 90,000 New Mexicans benefiting from the state’s decision to accept Medicaid expansion work in industries that are the foundation of the state’s economy, with jobs ranging from sales and food service to construction and health care, according to estimates in a study released today by Families USA.
This projected group of working New Mexicans represents an estimated 56 percent of the state’s residents who benefit from New Mexico’s Medicaid expansion, which went into effect last year.
“These statistics are an important part of the story about Medicaid in New Mexico,” said Barbara Webber, Executive Director of Health Action NM, a non-profit health consumer advocacy organization based in Albuquerque, NM. “We are thrilled that Centennial Care, including the very important Medicaid expansion for adults in our state, has contributed to the significant increase in health coverage for hard working families.
“This improved health access will certainly mean better health status for working families and increased productivity for the industries they represent,” Webber said. “This proves that Medicaid has been a win-win situation for New Mexico.”
Without Medicaid expansion, many of these people would have fallen through the cracks in the health care system – making too much for traditional Medicaid, but too little to qualify for subsidies on the insurance exchange, said Ron Pollack, executive director of Families USA.
“This study shows Medicaid expansion is a success story in New Mexico,” Pollack said. “The people it helps have tough jobs in industries that traditionally don’t provide health insurance. Now after a hard day’s work, they can sleep with the peace of mind that health insurance provides – knowing that a sudden accident or illness won’t wipe out their savings and dreams for the future.”
“Governor Martinez should be congratulated for her initial decision to expand Medicaid,” Pollack said. “The numbers contained in this study show how important this program is for so many of the working people of her state.”
Under Medicaid expansion, which went into effect in 2014, states can offer Medicaid coverage to residents with incomes up to 138 percent of the federal poverty level, which is $27,720 for a family of three. For the first three years, the federal government pays 100 percent of the costs. Starting in 2017, states will begin paying a small portion of the costs, which will be capped at 10 percent in 2020.