Thousands Of New Mexicans Stand To Gain Financial Help Buying 2017 Health Coverage, But May Not Know It

DHHS News:
 
Already, about 8.8 million Americans, and 32,703 New Mexicans, who buy health insurance through HealthCare.gov receive tax credits that help make coverage more affordable.
 
But about 12 million more Americans, including 45,700 New Mexicans, may also be eligible for help during this Open Enrollment, but not know it. This group includes:
  • Current HealthCare.gov consumers: 3,700 New Mexico consumers who didn’t get tax credits last year could be eligible for tax credits in 2017, even if their income remains the same, because financial assistance moves along with rates. That’s 22 percent of currently unsubsidized New Mexico Marketplace consumers.
  • Off-Marketplace individual consumers: About 8,000 New Mexicans who currently pay full price for individual coverage off-Marketplace could be eligible for tax credits if they purchase a 2017 plan through HealthCare.gov instead.
  • The remaining uninsured: About 34,000 uninsured New Mexicans earn incomes indicating they, too, could be eligible for financial assistance. Nationwide, 84 percent of Marketplace-eligible uninsured Americans have incomes suggesting they are tax credit eligible.
In New Mexico, 12,071 people have already signed up for coverage in the first month of Open Enrollment, more than last year at this time. But many more New Mexicans might benefit from visiting HealthCare.gov before the Dec. 15 deadline for January 1 coverage and checking out their options for affordable, quality health insurance.
 
Affordable by design. The Marketplace’s tax credits are designed to keep pace with premium increases. This means that for many consumers already receiving tax credits, the value of that financial assistance will increase this year to keep pace with the cost of coverage in their area. It also means that more individuals may qualify for tax credits as premiums rise.
 
For people eligible for financial assistance, the ACA specifies the share of income the consumer is expected to contribute toward health coverage. The tax credits make up the difference between that amount and the actual cost of a consumer’s benchmark (second-lowest-cost silver) plan.
 
For example, in 2017, a 27-year old in New Mexico making $25,000 per year will pay $142 per month to purchase the benchmark plan, almost exactly the same as in 2016.
 
That’s because the 27-year old will, on average, get an $82 tax credit – 165 percent higher than in 2016.
 
Check out your options. The Marketplace is open for business, and HHS is encouraging anyone who might need coverage next year to visit HealthCare.gov and check out their options before the December 15 deadline for coverage that starts January 1. Millions of Americans could be surprised to find out they’re eligible for financial assistance this year, even if they weren’t last year, giving them affordable, quality options to choose from.
 
Visit HealthCare.gov to browse and shop for quality, affordable health plans. More than 56 percent of current New Mexico Marketplace consumers will find plans for less than $75 per month, and the vast majority can save by coming back to actively shop instead of waiting to be re-enrolled in their current plan. 
 
The state-by-state tables below show the number of consumers nationally who could benefit in 2017 from the financial assistance Marketplace tax credits provide. If these consumers were to take advantage of the help offered on HealthCare.gov, they could find affordable, quality options.
 
Table 1. Availability of Financial Assistance among Current Health Insurance Marketplace Consumers
 
Percent  of Consumers Receiving Tax Credits in 2016*
Percent of Consumers Potentially Eligible for Tax Credits in 2017
Number of Unsubsidized Consumers in 2016
Number of Consumers Potentially Newly Eligible for Tax Credits in 2017
Percent of Unsubsidized Consumers in 2016 Who Are Potentially Newly Eligible for Tax Credits in 2017
Total
85%
89%
1,297,900
286,100
22%
AK
86%
90%
2,800
600
21%
AL
89%
93%
16,700
5,300
32%
AR
87%
90%
8,500
1,900
22%
AZ
74%
83%
45,700
13,200
29%
DE
82%
86%
4,700
1,200
25%
FL
91%
94%
138,700
34,800
25%
GA
86%
92%
59,700
14,300
24%
HI
81%
86%
2,600
600
24%
IA
85%
89%
7,300
2,000
27%
IL
75%
81%
89,300
22,000
25%
IN
81%
84%
33,800
4,800
14%
KS
82%
86%
16,800
4,200
25%
LA
89%
93%
19,300
4,400
23%
ME
87%
90%
9,700
2,400
24%
MI
83%
87%
50,800
10,000
20%
MO
87%
90%
31,100
7,100
23%
MS
90%
94%
8,500
3,000
35%
MT
83%
87%
8,900
2,300
25%
NC
89%
93%
52,700
13,100
25%
ND
85%
91%
2,400
600
26%
NE
88%
92%
8,500
2,200
26%
NH
66%
70%
17,000
1,600
10%
NJ
80%
84%
54,300
8,700
16%
NM
68%
76%
16,500
3,700
22%
NV
87%
90%
10,300
2,000
20%
OH
80%
85%
41,600
7,600
18%
OK
84%
88%
21,200
5,600
27%
OR
71%
78%
39,500
8,200
21%
PA
76%
82%
94,700
20,800
22%
SC
89%
92%
22,200
4,800
22%
SD
88%
93%
2,500
800
33%
TN
85%
89%
35,000
8,900
25%
TX
84%
88%
193,300
38,600
20%
UT
86%
90%
23,000
6,000
26%
VA
82%
86%
65,700
11,400
17%
WI
84%
87%
34,800
6,000
17%
WV
85%
89%
4,900
1,200
24%
WY
90%
92%
2,100
300
16%
 
* U.S. Department of Health and Human Services, “Addendum to the Health Insurance Marketplaces 2016 Open Enrollment Period: Final Enrollment Report,” ASPE Issue Brief, ASPE, March 11, 2016, available at: https://aspe.hhs.gov/sites/default/files/pdf/188026/MarketPlaceAddendumFinal2016.pdf.
 
Note: Plan information is from the plan landscape files and active plan selections in the CMS Multidimensional Insurance Data Analytics System (MIDAS) for 38 states using the HealthCare.gov platform in 2016 and 2017. Kentucky is new to the HealthCare.gov platform in 2017 and is not included in this analysis.
 
This analysis holds all enrollee characteristics unchanged and calculates 2017 premiums and tax credits based on the same age, family composition, and household income as in 2016. This analysis includes only enrollees who could be linked to complete plan and premium data for both 2016 and 2017, and excludes tobacco users. Consumers enrolled in catastrophic plans, which are not available to all consumers, were not considered in these calculations.
 
For additional details, see “Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace” (available at: https://aspe.hhs.gov/pdf-report/health-plan-choice-and-premiums-2017-health-insurance-marketplace).
 
Table 2. Consumers Without Health Insurance Marketplace Coverage Who May Be Eligible for Tax Credits
 
Off-Marketplace Consumers Potentially Eligible for Tax Credits*
Uninsured Consumers Potentially Eligible for Tax Credits
Total
2,488,000
8,988,000
AK
5,000
27,000
AL
33,000
136,000
AR
29,000
100,000
AZ
33,000
162,000
CA
313,000
740,000
CO
52,000
98,000
CT
15,000
44,000
DC
2,000
3,000
DE
5,000
20,000
FL
153,000
879,000
GA
95,000
361,000
HI
7,000
5,000
IA
41,000
66,000
ID
15,000
79,000
IL
130,000
211,000
IN
45,000
278,000
KS
28,000
84,000
KY
17,000
82,000
LA
34,000
110,000
MA
22,000
51,000
MD
31,000
102,000
ME
10,000
44,000
MI
62,000
206,000
MN
43,000
61,000
MO
83,000
259,000
MS
22,000
79,000
MT
14,000
26,000
NC
138,000
449,000
ND
4,000
16,000
NE
14,000
85,000
NH
3,000
23,000
NJ
44,000
171,000
NM
8,000
34,000
NV
27,000
63,000
NY
68,000
142,000
OH
64,000
272,000
OK
33,000
188,000
OR
26,000
81,000
PA
111,000
304,000
RI
4,000
14,000
SC
21,000
232,000
SD
17,000
28,000
TN
79,000
235,000
TX
252,000
1,629,000
UT
56,000
102,000
VA
56,000
264,000
VT
1,000
4,000
WA
53,000
185,000
WI
51,000
87,000
WV
15,000
36,000
WY
5,000
34,000
 
* Office of the Assistant Secretary for Planning and Evaluation, “About 2.5 Million People Who Currently Buy Coverage Off-Marketplace May Be Eligible for ACA Subsidies,” ASPE Data Point, October 4, 2016, available at: https://aspe.hhs.gov/pdf-report/people-who-currently-buy-individual-market-coverage-could-be-eligible-aca-subsidies.
 
Note: Estimates of the “Potentially Eligible for Tax Credit” exclude: adults with incomes at or below 200% FPL in Minnesota and New York, who are eligible for Basic Health Plan coverage; adults with incomes at or below 215% in the District of Columbia, who are potentially eligible for Medicaid; adults with incomes at or below 138% of the Federal Poverty Level (FPL) in all other Medicaid expansion states; adults with incomes below 100% FPL in states that have not expanded Medicaid (the “Medicaid gap”); children with incomes at or below 250% FPL in all states, who may be eligible for Medicaid or CHIP; individuals estimated to be immigrants not lawfully present; and individuals with incomes above 400% FPL. Numbers shown in table may not sum due to rounding.
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