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New Mexico

New Mexico had around 200,500 people without health insurance as of 2019, according to a report by the Kaiser Family Foundation (KFF), which represents about 9.8% of the state’s population. The nonprofit also looked at the number of uninsured again in 2021 and found that of the people still without healthcare coverage, approximately 94,300 of them could qualify for marketplace insurance.

Marketplace health insurance is the kind that’s regulated by the Affordable Care Act (ACA), which is the current healthcare law in the U.S. The ACA also guarantees coverage for pre-existing conditions and requires major medical plans to cover a set of 10 essential health benefits. These include things like preventive care, maternity care and prescription drugs.

The ACA also created advance premium tax credits, aka subsidies, to help people afford health insurance. Available to people earning 100% to 400% of the federal poverty level, these subsidies reduce what you pay out of pocket for the coverage itself.

According to KFF, nearly a fifth (18%) of the uninsured in New Mexico who qualify for marketplace coverage could get a bronze plan for free thanks to premium subsidies.

KFF also analyzed premiums by state in 2021 and found that the average lowest cost plans by metal tier in New Mexico were $236 a month for bronze, $328 a month for silver and $324 a month for gold. These averages don’t include the tax credits, but note that the average lowest cost for gold plans was slightly lower than the one for silver.

When we looked at examples using our own marketplace, we found that a 40-year-old in Roswell, NM, making $37,000 a year could find a bronze plan for just under $191 a month. That estimate does include a tax credit to lower the cost.

How much you pay for coverage, not to mention the availability of plans, depends on where you live. In New Mexico, there are at least 5 insurers offering marketplace plans in 2021. Among them are Molina, Centene, and Friday Health Plans.

Sources

Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)

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