NM high-risk health rates to increase

ALBUQUERQUE, N.M. (AP) – Insurance rates for people covered by New Mexico’s high-risk pool will go up nearly 24 percent, partly because enrollment is shrinking as more previously uninsurable people find coverage through a new health insurance exchange.

The head of the pool created by the state in 1987 said another reason for the premium increase taking effect July 1 is that the premiums are being brought more in line with those of other insurance products on the market, the Albuquerque Journal reported.

“Once the exchange was fully rolled up and you could see the difference in prices, we were no longer in line with what the market was,” said Deborah Armstrong, the pool’s executive director. “This still doesn’t bring us exactly in line, because rating factors (such as age and where the enrollee lives) aren’t exactly the same and the policies aren’t comparable.”

Armstrong said the pool’s costs for each person covered are rising because some previously enrolled people have obtained other insurance as a result of the federal health car law.

The pool now has 8,300 people enrolled, down from 10,000 before insurers began issuing policies under terms of the law.

Those terms include requiring insurers to issue policies to anyone, outlawing caps on medical payments over the life of the insured and prohibiting pricing of insurance based on the customer’s gender or medical condition

The pool is administered by Blue Cross Blue Shield of New Mexico. Companies that are licensed to sell health insurance in New Mexico are required to help pay the pool’s costs.

The pool’s board of directors last set the rates in the middle of 2013, before anyone knew what companies would offer on the insurance exchanges.

New Mexico residents can buy insurance from the pool if they have a qualifying medical condition, such as end-stage renal disease, or they have been denied individual coverage.

Others who can get coverage through the pool include people who can buy only insurance that limits coverage because of their health condition and those who can only buy coverage at rates that exceed a level set by the pool’s board.

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