Many New Mexicans depend on Medicaid for health care. KRWG student employee Kienna Rodriguez recently talked to Gabriella Rivera, the Policy and Communication Director for Health Action New Mexico, to learn more about how people can access healthcare resources.
Transcription (Some text has been edited for legibility):
Kienna Rodriguez
Gabriella, thank you for being here today.
Gabriella Rivera
Thanks for having me.
Kienna Rodriguez
How is your department working to address Medicaid coverage gaps in the state?
Gabriella Rivera
We've been involved in Medicaid for years, actually, since pretty much the inception of “Health Action New Mexico”, we've been involved in Medicaid. It's the predominant health system here for about 50% of New Mexicans around Medicaid. So it's absolutely something we concern ourselves with before I even came on, it was being involved in Medicaid expansion. Under the Martinez administration, and ensured that more New Mexicans could qualify, and we accomplished that, it's been a massive thing for New Mexico to be able to have that expanded Medicaid.
We've also for years been looking at, it's been under different names, previously was called “Medicaid Buy-In" now it's called “Medicaid Forward”, which is essentially opening up Medicaid to more people than just those who qualify for free Medicaid under that expanded Medicaid guideline. So that would be, someone who is above the threshold for Medicaid can buy into it, and stay on that same coverage for 10 or 20 bucks a month, 50 bucks a month (as your income gets higher) continue the same coverage that people know and trust, and at least have that as an option for folks to keep on that coverage.
So that's something we're working on right now. And then obviously, Medicaid unwinding is of a massive concern to us. A consequence of people staying on coverage through the pandemic, (which we encouraged, as it's not the time to kick someone off health insurance when there's a global pandemic going on) but we knew from the beginning that the provision of continuous coverage was going to end, and still it came as sort of a shock to states when it actually happened.
So from the beginning, we've been watching the states' plan for Medicaid unwinding. We actually felt pretty comfortable with the plan they laid out, confident that they were checking a lot of boxes, as far as how they're trying to reach people, genuine intent to keep people on. But as of right now, it's still not translating to keeping people on coverage, so that’s concerning.
Kienna Rodriguez
What resources are available for those who may not be eligible or who may have lost coverage?
Gabriella Rivera
If you did not fill out the paperwork, you know you thought you wouldn't qualify or you didn't get your envelope or whatever happened, but then you get a notice in the mail saying you no longer qualify. If you don't know for a fact, or if that's confusing to you, if you think you may still qualify for Medicaid, then we encourage you to appeal it or just reapply.
And once you're satisfied with the fact that you do not qualify, then there are some other ways of getting coverage. So, the first one is employer-sponsored coverage, this is something, especially for young people just out of college, who were getting their first job in the middle of the pandemic, or just turned 26, right? So you can keep your parents' coverage until you're 26 and then, you're dropped. They have never navigated an HR department, or the open enrollment for their workplace, so if you think you have access to employer-sponsored coverage, go to your HR department. If you were just dropped from Medicaid, then you qualify for a special enrollment period. So even if you see on your company's website or an e-mail or something, “open enrollment is over.” “You've missed the window to sign up.” If you have a qualifying life event like the loss of Medicaid, then they have to let you sign up.
If you don't have access to that, or if it's what we're finding is a lot of people can’t afford the employer-sponsored coverage that's offered to them. There are some ways of affording coverage after that. So first of all, if you don't have employer-sponsored coverage, you're allowed to go to Be Well New Mexico unless your immigration status does not allow that. So, if you're a lawfully present citizen or immigrant, then you qualify for Be Well New Mexico, it’s a Mexico Health Insurance exchange. And that's where all of the private plans are sold.
So, I think there's still some confusion about what Be Well New Mexico is. Basically, it's just where you go to buy Blue Cross Blue Shield coverage or anything else. And again, if you lost your Medicaid, then you're able to hop right over, you have a special enrollment period. It's kind of a lengthy special enrollment period where you can look at all the plans, and see what you can afford. There are a lot of subsidies on Be Well New Mexico, which makes it pretty affordable for most people, especially if you were of Medicaid qualifying threshold not too long ago, you should qualify for pretty affordable coverage, and the first month is free if you've just lost your Medicaid coverage.
So that's another incentive for folks to change over. And then if nothing's affordable to you, if nothing's accessible to you, sometimes you might qualify for the New Mexico medical insurance pool. And that's kind of the option of last resort, so you have to come, basically, with evidence that you've tried everything else, and you don't qualify, or you know for a fact something disqualifies you like your immigration status. So, there are options out there. Employer-sponsored coverage is not as affordable as we want it to be. So, if you're having a really difficult time affording that, we found out, that if it's something like above 9% of your income, then you still qualify for Be Well New Mexico. So, there are options, but I would start with your HR department and then Be Well New Mexico.
Kienna Rodriguez
Gabriella, thank you for being here today.
Gabriella Rivera
Thank you so much.
(Transcribed by Angelina Malone)
