One of the last four survivors of an Affordable Care Act (ACA) health insurer creation program is preparing to die at the end of the year.
The board of New Mexico Health Connections announced Tuesday that the carrier will continue serving enrollees through the rest of this year but will end operations Jan. 1, 2021.
Marlene Baca, the chairman of New Mexico Health Connections’ board, said, in a comment included with the shutdown announcement, that claims have been too high, enrollment growth has been too slow, and capital has been too scarce for the carrier to stay in business.
“Rather than spending resources on next year’s uncertain market, we would rather make sure we protect our current members,” Baca said.
New Mexico Health Connections is working with the state’s Office of Superintendent of Insurance and the federal Centers for Medicare and Medicaid Services to make sure that it meets all deadlines and fulfills obligations to current members, Baca said.
Because New Mexico Health Connections is closing voluntarily, it can ensure that enrollees can continue to see their plan doctors ,and that claims will continue to be paid under the terms set forth in plan documents at the beginning of the year, according to New Mexico Health Connections.
“As always, members will need to pay monthly premiums in accordance with plan rules for their coverage to remain in effect for 2020,” the carrier said.
New Mexico Health Connections is based in Albuquerque, New Mexico.
In 2018, the carrier had about 17,000 individual coverage enrollees and was the second biggest player in the New Mexico individual major medical market, after Molina Healthcare, according to data compiled by the Henry J. Kaiser Family Foundation.
Russell Toal, the New Mexico insurance superintendent, confirmed in a statement that New Mexico Health Connections enrollees will be able to keep their coverage until the end of the year and have service claims paid.
New Mexico’s Individual Market
Many New Mexico residents with individual health coverage get their health coverage through BeWellNM, a state-based Affordable Care Act public exchange program, which started the year serving about 43,000 people.
“Even with the departure of Health Connections, this fall New Mexico will have more health insurers offering plans in the marketplace than ever before,” Toal said in the comment.