BeWell - New Mexico's Health Insurance Marketplace CEO Alex Sanchez explains what New Mexicans can expect when shopping for a health plan during open enrollment. Here is a transcript of the interview with KC Counts:
KC Counts:
Why don't we start with just the basic things people need to know about open enrollment for the marketplace?
Alex Sanchez:
Sure. So open enrollment is officially going. This is the time of year where New Mexicans who don't have coverage through their employer, they don't qualify for Medicaid or Medicare, can come and select a plan on the exchange. This is also the only place where they can qualify for subsidies to reduce the cost of health insurance. BeWell is often kind of thought of as part of the Affordable Care Act or what some people call Obamacare, right? We offer plans from trusted carriers, Molina, United, Blue Cross Blue Shield, Presbyterian, we have dental plans. And then you can qualify for subsidies depending on your zip code, your household size, and your household income.
KC Counts:
Why does zip code make a difference?
Alex Sanchez:
There are different rating areas. So, healthcare costs are determined on your rating area. So, depending on what zip code you're in, you're in a different rating area, which could change the cost.
KC Counts:
All right. So obviously there are some big question marks here for people as we are having this conversation on Thursday, November 6th. Things could change by the time this actually airs for our listeners. But as of today, what are people seeing when they go to enroll for their new plan?
Alex Sanchez:
Yeah, New Mexicans are extremely lucky to live in a state where the state legislature and the governor have committed to affordable and reliable health insurance. So if you come to BeWell and you come shopping for a plan, you're going to see state assistance that is supplementing loss of federal tax credits. So the debate right now in Washington is about these federal tax credits that are set to expire at the end of the year. They affect a majority of BeWell customers, but the state has agreed to supplement state funds for those losses. So really the only people who will need to wait a couple of days for the system to do the calculation are those with very high incomes that the state addressed in the special session, or those who are below 100% of the federal poverty level who don't qualify for Medicaid due to their immigration status. Those are the only two groups. And if you come in and enroll, then you give it a few days, the calculation will process between October and the November 1st start date. So, between the special session and the November 1st start date, we just couldn't get the calculations in time. But those are folks over 400% of the federal poverty level. We do have those listed on bewellnm.com. if you’re curious what yoursubsidylevel is, but I will tell you, it is a complicated year for health insurance. Let us do the work for you. We will, for free, help you fill out the application, select a plan that's right for you, ensure you're getting all the subsidies you qualify for, and get you enrolled. So we can take a lot of stress off of you completely for free.
KC Counts:
What do you find is the biggest challenge right now for people navigating the process and for those who are helping them do so?
Alex Sanchez:
I think honestly, the biggest challenge we hear right now is the difference between what's happening in the rest of the country and what's happening here in New Mexico. So if you're listening to the national news, if you're hearing these things about subsidies and changing or prices going up to three times the amount. We are different here in New Mexico, thank you to the work of the state government, legislature, and the governor's office. So we're seeing a lot of people coming in cautious that they think insurance is not going to be affordable. And when we really walk it through with them and help them understand their eligibility, we are seeing a lot of people who are very grateful, you know, people who are, oh, now I understand. I also think something to keep in mind is there have been historic plan increases, the cost of actual insurance plans. And New Mexico is no different. So insurance will cost you more this year, on average, 36% more. But you're going to have these subsidies that really help offset a lot of those costs.
KC Counts:
We've talked a lot about the ripple effects of federal policy. And there are certain parts that you mentioned - the increase and parts of that, you know, even state legislatures can't control. What in terms of the near future are you going to be looking for in terms of things that will impact New Mexicans?
Alex Sanchez:
Yeah, we're really going to be watching what does happen with the federal government. Ideally, enhanced premium tax credits are continued. If that happens, the system would revert to apply those federal dollars instead of state dollars to the plans. So ideally, that would be what we are hoping for and we're watching for, right, to put that money back from the federal government into plan subsidies. I think the other thing we're really watching for is just the changes from the Big, Beautiful Bill will continue to roll out over time. Even though the bill was passed last Summer, there's going to be deadlines in it. They go for several more years. And it will change health care. And so people who currently have Medicaid and who no longer are going to be eligible, BeWell is here to help you, help you find a plan that's affordable for you. And at the moment, for our current enrollees, more than 50% pay less than $10 a month. So we still have very affordable plans, and we have a lot of options for you.
KC Counts:
Earlier, you mentioned people without legal status, immigration status, obviously a huge concern across the state of New Mexico. What are you seeing in terms of people coming to BeWell for health insurance?
Alex Sanchez:
Well, you know, there are certain eligibility criteria. The Big, Beautiful Bill did get rid of F1 visas. And a lot of times you think of that asstudent visas, right? So we are seeing that, that's going to end, eligibility will end for that next year. As far as like, DACA members, they were notified that their eligibility is no longer accepted here. But we worked really closely with the Healthcare Authority to provide a coverage plan for those folks for the rest of the year. We've worked really hard with those who have an immigration status issue to really go over what are they eligible for. And BeWell has an open door approach. So if you come to us and you're Medicaid eligible, that application immediately goes over. You don't have to fill out a new application. If you come to us and you're not eligible due to your immigration status, we're going to help get you over to the New Mexico insurance pool. Can they help you? Can they provide you coverage? So we're here to talk about your options. If you are coming concerned that your immigration status is going to be shared, BeWell does not actively share that information. So it's not something that we are going to report out on immigration status by enrollees.
KC Counts:
All right, sounds like there's still a very complicated process for a lot of people in New Mexico.
Alex Sanchez:
And I would say it's across the country. I don't think it's even a New Mexico thing, right? Health insurance is complicated in general, right? Like all of us have plans and then something happens and you're like, wait, that's not covered or this is covered, right? So it can be very complex and confusing and something especially hard for working New Mexicans.At the end of the day you're trying to sign up for health insurance. We don't want you frustrated. We don't want you coming in, creating an account, and then not moving forward. We want you to have coverage. You know, I keep saying we want you to get your kiss and we want you to get your health insurance card at midnight, you know, 12:01 a.m. on January 1st. So we really want to make sure that you have the resources you need and that you are having all the eligible subsidies applied to your account. The best way to do that is get help from a certified assister who will do all that work for you for free. And these people are trained, they're not going to push a certain plan one way or another. They're really going to go over what your needs are.
KC Counts:
So are those people accessible by phone?
Alex Sanchez:
Absolutely. So great news - you can come to bewellnm.com forward slash appointment and you get to decide. You can choose your certified assister that you want to speak to. Some of them offer Zoom sessions. Some of them you can call. Some of them you can see in person. You can come to one of our events. You can call our call center. You can also chat with us online. We are here to meet you where you want to meet us. We also have virtual enrollment events, which happen weekly. These are by far our most popular events because you can join from wherever you are. If you were at your kid's dentist appointment, great. Let's get you health insurance, right? If you are on the soccer field - we had a guy last year who I adored - joined us in the middle of a hunting trip with his friends. Like you can really join us from wherever and we'll get you insured.
KC Counts:
So bewellnm.com, still the website to go to. Although it's just BeWell now.
Alex Sanchez:
It is BeWell, yeah. And 833-862-3935 is the number to call to get help. Our call center is open Monday through Friday, 7 A.m. to 7 P.m. during open enrollment and Saturdays from 9 a.m. to 2 p.m.
KC Counts:
Okay, Alex Sanchez, chief experience officer for BeWell, thank you so much for spending this time with us. I know it helps a lot of people to just get a little bit of guidance at such an uncertain time. Thank you.
Alex Sanchez:
Thank you.
You can access BeWell, New Mexico's Health Insurance Marketplace right here.
