Improving Consumer Engagement with the New Mexico Health Insurance Exchange

The Patient Protection and Affordable Care Act (ACA) provided millions of low- and middle-income Americans with access to subsidized health coverage through state-based health insurance marketplaces in 2014, including New Mexico’s beWellnm. However, many lower-income New Mexicans eligible for subsidies—especially racial/ethnic minorities and those living in rural areas—didn’t initially sign up for coverage.

In late 2015, beWellnm commissioned AIR and its research partner, Lovelace Scientific Resources, to assess why subpopulations of New Mexicans eligible to receive financial subsidies had not enrolled in health insurance and recommend how beWellnm could tailor outreach and support to increase enrollment. Researchers conducted a literature review, interviews, and focus groups to identify challenges that rural New Mexicans faced in learning about beWellnm and enrolling in a health plan.

The project’s final report—New Mexico Health Insurance Exchange: Consumer Behavior and Stakeholder Engagement Market Assessment Report (PDF)—included the following recommendations:

• Focus outreach on positive messaging of interest to uninsured New Mexicans with less emphasis on the tax penalties for being uninsured.
• Provide easily accessible and detailed information about tax credits and cost-sharing subsidies, the process for applying to receive a subsidy, and where people can go to find out if they qualify.
• Develop innovative ways to reach subsidy-eligible uninsured people through local news broadcasts, ethnic media (local and internet radio stations and newspaper), the internet, text messaging, email, and phone.
• Engage people trusted by the uninsured, such as healthcare providers, as advocates for becoming insured.

• Assess consumer-facing informational and enrollment resources and assistance to identify and correct interfaces that stop the uninsured from moving forward to enrollment.
• Adopt the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care.