New Mexico To Keep Administering High-Risk Insurance

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A panel of New Mexico regulators has voted to continue coverage for more than 1,500 people who are part of a federal high-risk health insurance pool despite a likely shortfall in payments from the federal government.

The state board that oversees the pool voted unanimously Friday to continue coverage for the Preexisting Condition Insurance Program.

Claims are expected to out-pace federal payments by almost $6 million this year, the Albuquerque Journal reported. By statute, the extra cost will be absorbed by health insurance companies. In turn, they’ll get some tax relief.

The program was established as part of the Obama administration’s health care overhaul effort, known as the Affordable Care Act. It’s aimed at helping people with preexisting conditions get affordable coverage until more provisions of the act take effect in January.

The board had the option of canceling its agreement to administer the program. That would have forced members to re-enroll in a version of the program administered by the federal government, and that could have resulted in significant costs for members.

“Our first concern is for the citizens of our state,” said State Insurance Superintendent John Franchini, who also chairs the New Mexico Medical Insurance Pool.

Franchini said the board wanted to make sure the members of the pool get the same benefits they were promised until the end of the year.

Officials with the New Mexico Medical Insurance Pool said they would also find ways to contain costs.

The Preexisting Condition Insurance Program has been struggling to pay its bill nationally because it seriously underestimated the cost of insuring the very sick and often low-income people who qualify for high-risk pool insurance, said Reena Szczepanski, executive director of NMMIP.

The program expected to enroll up to 400,000 people nationwide and had a $5 billion appropriation to care for them. Only 135,000 have been enrolled and the money is nearly gone.

Federal officials ordered the New Mexico pool to stop enrolling new members last March. Szczepanski said 79 qualified people have since been denied coverage through the program.