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At least 63,900 New Mexicans must change health care policies

By   /   October 29, 2013  /   News  /   No Comments

By Rob Nikolewski │ New Mexico Watchdog

SANTA FE — At least 63,900 people in New Mexico have been notified they’re going to have to change their individual health care policies — some must do it within a matter of months while others can wait until end of next year — according to a review by New Mexico Watchdog.

One of those people who will see his coverage change is Jerry Hardin of Albuquerque and he’s not happy about it.

FIND ANOTHER POLICY: A review from NM Watchdog shows that nearly 64,000 holders of individual policies in the state will have to change their coverage.

FIND ANOTHER POLICY: A review from NM Watchdog shows that nearly 64,000 holders of individual policies in the state will have to change their coverage.

“I have had a lot of things done in the last few months,” the 58-year-old Hardin told New Mexico Watchdog. “I went to the cardiologist, had a procedure done with my eyes and it didn’t cost me a whole lot. Now everything’s changing and getting more expensive.”

Earlier this month, Hardin received a letter from the University of New Mexico health care plan he belongs to — called UNM Care — informing him his policy will be cancelled by the end of next March.

About 27,000 Bernalillo County residents get their health care from UNM Care and they’ve been notified if they don’t qualify for Medicaid, they’ll have to look for individual coverage, according to KOB-TV. Officials at UNM Care say the program will continue as a supplemental form of coverage and guess that about 75 percent will be eligible for Medicaid.

Lovelace Health System has notified 2,900 that their individual policies have been cancelled at the end of this year and they must buy new policies that are compliant with the Affordable Care Act, colloquially known as Obamacare.

There are 28,000 people on individual policies at Blue Cross Blue Shield of New Mexico, according to Janice Torrez, vice president of external affairs. Of that number, 17,000 can be grandfathered in with the policies they own (provided they make no changes) and the remaining 11,000 can keep their policies for one more year. After that, Torrez said, those 11,000 have to move to a plan that is compliant with the ACA.

Some 23,000 people currently on individual policies with Presbyterian Healthcare Services received notices their coverage particulars were changing. “Some people didn’t like it, of course, but we didn’t get a whole lot of complaints,” said Neal Spero, vice president of sales and marketing.

Spero said Presbyterian offers three options for those who don’t have plans that are grandfathered, including staying with their current policy for another year before moving to a policy that is ACA-certified.

The total for all four providers comes to 63,900 people in New Mexico who will have to change individual policies:

changes in health care box

The total compiled by New Mexico Watchdog is not comprehensive and there are almost certainly other providers who have sent out similar notices to individual policy holders in New Mexico.

That’s the part that angers Hardin, who’s been looking for work most of this year and likes his current policy.

“I don’t want to change it but after hearing all the news I was kind of expecting this letter (from UNM Care),” Hardin said.

Individual policy holders in New Mexico are not alone.

Blue Shield of California sent termination letters to 119,000 customers last month because their policies don’t meet the more robust standards of coverage required by the ACA. Kaiser Permanente is cancelling coverage in California for about 160,000 people.

In Florida, Kaiser Health News reported that that Florida Blue is dropping 300,000 policies, which make up 80 percent of its individual policies in the state.

In Pittsburgh, Highmark is cancelling 20 percent of its individual market customers, and in Philadelphia, Independence Blue Cross is cutting off 45 percent of its individual policy holders.

“I was for Obamacare until I found out I was paying for it,” one woman reportedly said in a letter to the president of Anthem Blue Cross in California.

Officials at Presbyterian, BCBS of New Mexico and Lovelace say they’re trying to make the transition as easy as possible.

“The biggest question out there is, what is this going to cost?” BCBS’s Torrez said. “I would say that in our state a lot of people will get subsidies.”

Under Obamacare, people whose incomes fall under 400 percent of the federal poverty level ($94,200 for a family of four) are eligible for federal subsidies to reduce their premiums.

The catch?

In order to sign up for the subsidies, you have to go to the www.healthcare.gov website, which has been plagued with computer glitches since it rolled out Oct. 1.

Customers “want to get on the exchange and see what that want to do but they can’t get on the exchange,” Spero said.

“It’s certainly been difficult for folks eligible for subsidies,” Torrez said. “We are hopeful (the www.healthcare.gov site) will be fixed very soon and we can move forward.”

However, Presbyterian and BCBS officials say if you don’t qualify for federal subsidies you can skip going to the troubled federal website and go shopping and even sign up for individual policies on their respective websites — www.phs.org or call 1-800-ASK PRES for Presbyterian and www.bcbsnm.com for Blue Cross Blue Shield of New Mexico. Lovelace offers its own website, www.healthcareinformednm.com, and a hotline at 1-855-897-4630.

But what about President Obama’s famous quote? “If you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan,” he said in 2009. “Nobody is talking about taking that away from you.”

Spero acknowledges those on individual policies tend to see more of an increase in premiums and deductibles.

“The ACA has a very rich benefit plan,” Spero said, “but it, in turn, costs more money … On the positive side, people have access to health care and that’s a good thing, but there are changes.”

People like Jerry Hardin didn’t want to see any changes at all.

“I’m ticked off about it,” Hardin said. “(Obama) flat-out lied to us about it. He was ardent about there not being any changes when he introduced the Affordable Care Act.”

Contact Rob Nikolewski at [email protected] and follow him on Twitter @robnikolewski


Rob formerly served as staff reporter for Watchdog.org.