Getting ready for health care
Despite the many attempts by the GOP majority to reduce health care coverage in the United States, the Affordable Care Act remains the law of the land — for now, anyway. And citizens who need insurance were able to start signing up for coverage his week. But they should not postpone shopping — the open enrollment period is shorter than in past years, with a deadline of Dec. 15 instead of in January.
New Mexicans will have help sorting through various insurance plans this year, thanks to a new consumer portal set up through the New Mexico Office of the Superintendent of Insurance. It has a somewhat unwieldy name — OSICompareHealthPlans.org — but the site offers customers an easy-to-search format so that they can compare all plans certified in New Mexico. (Only plans eligible for subsidies are available on the federal site; having all plans available for comparison will help consumers not receiving subsidies.)
The state consumer website won’t replace healthcare.gov, the federal portal where consumers enroll in a health plan. It also isn’t a substitute for bewellnm.com, a state website that also offers counseling and health insurance information. Instead, the consumer site supplements both.
With health care costs so expensive, a one-shop stop where consumers can compare benefits and prices is welcome. This enrollment period, the federal government is doing less outreach to remind people to sign up for health care, so consumers should take advantage of assistance that helps them select the best plan.
Here’s what health insurance shoppers can do: Go to OSICompareHealthPlans.org and look up plans. Once a buyer finds one that might work, he can write down the plan identification number and enroll at healthcare.gov if eligible for a subsidy or tax credit. Otherwise, go straight to the company or a broker to purchase insurance.
At the consumer portal, buyers will find doctors included in the plan, the medicines that are covered and the many different insurance choices. Evidently, a buyer’s questions can be answered in a few minutes — now that’s a useful site. The consumer site also helps buyers figure out, based on income, whether they might be eligible for federal subsidies to help pay for insurance (for now, those are still available).
Such subsidies are important in New Mexico, considering that, of the 50,000 or so customers who bought insurance in New Mexico through the exchange in 2017, more than half qualified for some cost-sharing assistance or advanced tax credits. Those helped offset the costs of monthly premium payments.
Many buyers qualify for help to pay for premiums — they can be used by people with gross incomes between 138 percent and 400 percent of the federal poverty level. For 2017 policies, any person with a gross income below $47,520 (or a family of four with an income less than $97,200) can get a subsidy. With inflation, those numbers rise to $48,240 and $98,400 for policies sold this fall for 2018. Even though premiums for many insurance plans have increased, heftier subsidies could actually make the cost of purchasing health insurance less expensive. To obtain a subsidy, insurance must be purchased through healthcare.gov or a state exchange.
That’s why a comparison portal is so useful. Developed by the nonprofit Consumers’ Checkbook organization, the portal has been customized to specific states. The Office of the Superintendent of Insurance is paying a $190,000 licensing fee so that it works for New Mexico plans and providers. It offers a wider range of what is available, including options for customers who aren’t receiving federal help.
Navigating the health insurance maze is no easy task, especially when the enrollment period is limited and the different options overwhelming. A website that helps consumers sort through the choices and find a plan they can afford — and that covers what they need — is just what the doctor ordered.