ALBUQUERQUE — A new report by Health Action New Mexico shows that premiums may be much less expensive in 2018 for New Mexicans who receive financial assistance under the Affordable Care Act. The report uses data from healthcare.gov to show the lowest cost options in each plan category that are available for the 2018 plan year. One example shows that a family of four earning $70,000 per year in Roswell, NM could cover the whole family with a Bronze plan for $0 per month, a Silver plan for $484 per month, or a Gold plan for $220 per month. Bronze plans offer the least financial protection while Gold plans generally offer the most. For lower income consumers, Silver plans offer enhanced financial protection through cost sharing reductions.

“For those who qualify for financial assistance, many marketplace plans will be much less expensive than ever before” said Colin Baillio, Policy Director of Health Action New Mexico. In 2017, 73% of marketplace enrollees qualified for premium assistance, while 38,000 uninsured New Mexicans are eligible for assistance. “If early trends are any indication, we may see a big boost in enrollment as people take a look at the great deals that are available.”

The shift in prices is mostly attributed to insurers and state regulators reacting to the Trump administration’s decision to end cost sharing reduction payments. Insurers are still required to discount co-payments, coinsurance, and deductibles for lower income enrollees but the federal government will no longer reimburse them for it. Ending these payments has caused premiums to go up. 

However, premium assistance is still available, and because it rises alongside increases in the benchmark silver plan, plans that have risen at a slower rate have become much more affordable. On the other hand, those who don’t qualify for financial assistance will likely find themselves in a situation where premiums are substantially higher than they were last year due to the Trump administration’s actions. Still, other plans may be a better deal than others, such as the lowest cost Gold plan which costs less than the lowest cost Silver plan.

“People should use New Mexico's brand new plan comparison tool OSICompareHealthPlans.org to see if they qualify for a no-cost or low-cost plan,” said Baillio. “If you don’t get coverage from your job or a public program, we encourage you to take a look at what is available. We’ve heard from quite a few people who were surprised by the great deal they got. It’s important to shop around and see which plan works best for your family. Once you find a plan that you like, visit healthcare.gov to sign up.” 

The Kaiser Family Foundation found that nationally "70% of subsidy eligible-uninsured are able to purchase a Bronze plan for nothing or less than the cost of the individual mandate penalty." The penalty for lacking insurance is $695 per adult or 2.5% of income, whichever is higher.

Open enrollment is underway and ends on December 15, 2017. Free local assistance is available at BeWellNM enrollment centers.