New Mexico should use its health insurance exchange to help drive reform and protect consumers, said a report released Monday by a group charged with getting the state ready for the nation’s new health care law.
At the center of the nation’s new federal health care law are health insurance exchanges. They must be up and running by 2014. In essence, the exchanges should function as a clearinghouse for consumers looking to purchase health insurance.
But one of the questions put to the Gov. Bill Richardson-appointed panel of state cabinet secretaries and top aides that produced Monday’s report was what type of exchange New Mexico should create.
The group’s report left little ambiguity about which one it favored.
Here’s an excerpt from the report:
Recommendations to the Leadership Team were that New Mexico should develop an Exchange that assumes an active role in driving market reforms and protecting consumers. This could include restricting plans from the Exchange that would exceed specified premium growth levels or by requiring cost containment initiatives of plans participating in the Exchange. While some states have developed Exchanges that merely serve as a market organization and distribution center for health care plans, it is recommended that New Mexico develop a strong Exchange that promotes competition between plans based on quality and price in a way that is transparent to consumers.
Monday’s recommendation came after a months-long process in which the cabinet secretaries and their top aides hashed through issues that New Mexico likely will confront as it prepares for 2014, the year when most of the law’s biggest programs go into effect.
What type of exchange New Mexico should create came up more than once during the group’s deliberations through the spring and early summer.
A former state official from Massachusetts told the group that deciding what kind of health insurance exchange New Mexico wanted would be one of the most important issues before New Mexico. Massachusetts created the nation’s first health insurance exchange. Massachusetts’ experience helped shape and influence what ended up in the federal health care law.
In addition to the governor-appointed group, a group headed up by New Mexico state lawmakers also has been preparing for the new federal health care law, even exploring competing health insurance exchange models.
Massachusetts may have created the nation’s first health insurance exchange. But New Mexico’s neighbor, Utah, set up a competing model with a pilot program this year.
In many ways, the two models are a study in contrasts.
Massachusetts mandates that every state resident be insured and that companies must offer workers coverage — or face a stiff penalty.
Massachusetts’ goal was to bring nearly universal health coverage through the exchange, which was envisioned as a place for uninsured or under-insured state residents to find affordable health insurance policies. Some Massachusetts residents who couldn’t afford health insurance qualified for financial subsidies.
The state of Massachusetts, meanwhile, plays a significant role in how the exchange is operated, with dozens of state employees dedicated to overseeing the program.
Utah, on the other hand, started a pilot health insurance exchange for employers with 2 to 50 employees this year. Unlike Massachusetts, there is no insurance mandate. And in Utah the agency overseeing the pilot program has two employees and $600,000 annual budget.