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Health exchange: A promise of savings delayed

By Staci Matlock
The New Mexican

Self-employed small-business owner Bryana Mares and others like her are among those who could benefit most from New Mexico’s health insurance exchange.

The Santa Fe resident has watched her insurance rates and her monthly premiums climb every year, and she calculates they’ve jumped 50 percent in five years. “I think that’s absolutely ridiculous,” she told state regulators at a public hearing in 2012 as Blue Cross Blue Shield of New Mexico, her insurer, sought yet another rate increase.

She was among dozens of self-employed, self-insured and angry New Mexicans who protested against the rate increase.

Now they could reduce their insurance premiums and end up with better coverage under the New Mexico Health Insurance Exchange that launched Oct. 1 as part of the federal Affordable Care Act. But first they have to enroll through a new federal online system that’s been plagued with problems.

Mares tried the system last week on bewellnm.com and didn’t make it past the application process before the computer system kicked her off. “It seems a little difficult, but those who are more computer literate probably will have an easier time. It is definitely a process,” she said.

She’s not frustrated. “I’m of the philosophy that this is brand new and it will take some time,” Mares said of problems with the federal site. “Medicare and Medicaid took time and didn’t start perfect. You tell me the last time the government started any program that was perfect.”

The national system was overwhelmed when hundreds of thousands of people tried to log on and enroll in an insurance plan on the first day. The federal government and companies contracted to design the insurance exchange are working to fix the problems. The federal government hasn’t released any information to the states about how many people have successfully enrolled in the exchange, according to Debra Hammer, communications director for the New Mexico Health Insurance Exchange.

In New Mexico, signing up through the insurance exchange is only a problem for people seeking individual or family plans. That portion of the state’s exchange is handled by the federal system. The New Mexico Health Insurance Exchange is managing the plans offered to small-business owners, and the Human Services Department is handling expanded Medicaid insurance. Neither of those programs have reported problems.

Mares said she’ll talk to an insurance broker and try again in a few weeks. She’s got time.

The law requires everyone who isn’t already insured to sign up for health insurance by March 31, 2014, or pay a fine. Mares is already insured, but she figures the exchange could save her some money.

She’s paying $511 a month now. Recently, Blue Cross Blue Shield sent her a letter saying her insurance would climb another 10 percent by January.

Mares did try a small cost calculator at the bottom of the bewellnm.com site. The calculator, set up by Kaiser Family Foundation, gives people a quick estimate of their health insurance premiums and subsidies under the exchange.

Mares doesn’t qualify for a subsidy, but even without it the calculator told her she could save quite a bit for a silver-level health plan. The five companies approved to offer individual and family insurance under the New Mexico exchange have platinum, gold, silver and bronze plans with different types of benefits.

For a silver plan, the calculator told Mares she would pay about $2,535 a year or $211 a month, a substantial savings over what she pays now to Blue Cross.

Some people have been able to enroll through the federal program.

Taos musicians Kim Trieber and Robert Chipper Thompson said they are delighted with the health exchange. Trieber posted a thank you note to the president last week on Facebook. “Thank you Barack Obama … as of today, my husband and I will be fully insured for medical and dental on an affordable health care plan,” she wrote. “After two hours of Internet glitches, our local insurance broker (on her own time) came to the Taos Living Center to help folks like me enroll in this historic event of affordable health care.

“We are the exact demographic that needs this plan,” Trieber continued. “We fall over the Medicaid eligibility requirement by $1,000, and yet, earn nowhere near enough to pay the ‘normal’ insurance premium, with pre-existing conditions.”

Until last week, the couple didn’t go for regular checkups and didn’t go to the emergency room even when they were ill. Beginning Jan. 1, they’ll pay a monthly premium of $117.46 for both of them. They’ll have no copay, no deductible, and will be able to get all the basic tests they need.

Hammer said that while the federal government works out the program’s kinks is a good time to check out the plans, gather paperwork needed for the application and perhaps consult with a state health insurance guide or private insurance agent. A list of agents and guides, as well as a map of their locations, is available at bewellnm.com. There is no cost for talking to agents or guides.

“People are going on the site every single day, but many don’t know what they need,” Hammer said.

Under the state-run insurance exchange, more than 800 small businesses had applied as of Oct. 23. Their employees will be able to choose a health care plan partially paid for by their employers beginning Nov. 1.

Contact Staci Matlock at 986-3055 or smatlock@sfnewmexican.com. Follow her on Twitter .

Read more: http://www.santafenewmexican.com/news/local_news/health-exchange-holds-promise-of-savings/article_9a8ea1c5-8ddb-5d59-a055-24a3696782f2.html#.Um5PAJ0tKoI.twitter

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