1,900 Otero County Residents Could See Health Premiums Rise
State lawmakers fund temporary fix as federal Enhanced Premium Tax Credits sunset Dec. 31. What does that mean for New Mexicans in Otero County?
By Elva K. Österreich
Southern New Mexico Journalism Collaborative
Federal health care subsidies were a major sticking point in a stalemate that led to a 43-day federal government shutdown, the longest in U.S. history.
The shutdown ended last month. But Congress did not restore expanded insurance subsidies known as Enhanced Premium Tax Credits, a pandemic-era benefit that reduced health insurance costs and expanded access for millions of Americans who get their coverage on state-run marketplaces. The subsidies result in savings – sometimes up to several hundreds of dollars per month – for people without other health coverage options.
While political debate continues to swirl nationally, absent new action by Congress, these federal subsidies will sunset Dec. 31.
But what does this mean for the roughly 75,500 New Mexicans on the state marketplace, known as BeWellNM, the majority of whom benefit from the subsidies?
NM actions stall subsidy sunset
Nov. 1, enrollment opened for people to dip into New Mexico’s marketplace and sign up for insurance coverage for 2026, according to Alex Sanchez, chief experience officer for BeWell New Mexico.
But because of actions this year by the state Legislature, most residents qualifying for EPTCs will continue receiving a state-funded version of the subsidies – at least for now.
“In New Mexico we are very blessed that we live in a state that has committed to affordable reliable health insurance,” Sanchez said.
Even so, many customers are likely to see their premiums increase due to rising health care costs.
The Big Beautiful Bill, passed by Congress and signed by President Trump this summer, impacted the affordability of insurance and changed some eligibility requirements, Sanchez said.
In January of this year, the state legislative session took action to prevent subsidy losses for residents who earn income up from 100% to 399% of the federal poverty level. In December, there were about 51,100 New Mexicans within this income range who were marketplace clients.
Meanwhile, a second category – those earning 400% or more of the federal poverty level – also would have seen EPTCs disappear if not for further action by the Legislature in its October special session. State lawmakers allocated state funding to supplant the federal dollars that would have supported the sunsetting ETPCs.
About 7,900 New Mexicans fall into this category of higher earners, according to a state dashboard. These residents would have lost their tax credits for 2026, making their monthly bills go up by hundreds of dollars, if the state Legislature hadn’t restored funding for the subsidies, Sanchez said.
The cost to the state to foot the bill for EPTCs for those earning 400% of the federal poverty level is expected to be about $17.3 million through the first half of next year, according to legislative estimates. The fix is temporary because the state works on a fiscal year which ends on June 30.
“Next year we fully expect the (state) Legislature will take up this issue again,” Sanchez said.
In Doña Ana County, about 10,300 people are enrolled in coverage through the exchange, according to state numbers. Some 1,900 people are in Otero County, while nearly 1,800 are signed up in Eddy County.
Cost increases expected anyhow
Within the first two weeks of enrollment for 2026, nearly 71,800 consumers had applied for coverage for the 2026 cycle, according to bewellnm.com. New Mexico’s open enrollment on the marketplace, also known as the exchange, continues through Jan. 15, 2026.
“Those who don’t qualify for Medicaid or Medicare or have had insurance through their employer can come to BeWell New Mexico’s health insurance marketplace and enroll in coverage,” Sanchez said.
Some residents at or below 100% of the federal poverty level who don’t qualify for Medicaid due to their immigration status will also qualify for the state-version of EPTCs, also due to the Legislature’s action in the special session.
New Mexicans are still likely to see cost increases in the year ahead, even with the state version of EPTCs in place.
“I think the biggest thing to remember is there’s been historic rate increases across the country and in New Mexico that average rate increases 36%,” Sanchez said. “So even though the state is supplementing the loss of federal money, in a lot of cases customers are going to see their bill change.”
Congressman backs federal subsidy extension
During a roundtable event held Sept. 24, Congressman Gabe Vasquez of New Mexico’s 2nd Congressional District talked about the Affordable Care Act premium tax credits set to expire this year. He said changes in legislation and the loss of tax credits would tend to squeeze out certain people in the middle class out of coverage, as well as those who earn less.
If the subsidies end, Vasquez said the average New Mexican could expect to see increases in their insurance rates, including people covered under private insurers. This would likely reduce the overall population in New Mexico covered by healthcare, as people decline coverage due to higher costs. He said he supports restoring EPTC funding at the federal level.
“We are looking for a permanent extension of these health care benefits which specifically target people at the 400% of the federal poverty level, so we are not just talking about low income families or individuals, you are talking about the middle class,” he said. “This is a tax credit designed to help the middle class so they don’t have to make that tough choice of being able to pay their rent or mortgage or being able to go to the grocery store and how many groceries you can afford.”
Vasquez asserted the state of New Mexico is not going to fund the cost of the coverage gaps forever.
Even before New Mexico lawmakers stepped in to supplant the loss of federal subsidies, the state funded a version of premium assistance, Sanchez said. This year’s legislative actions simply boost the levels of state-funded assistance for consumers, but only until the federal government restores EPTCs – if it does at all.
Trickledown effects
Virgil Medina, CEO at the nonprofit La Clinica De Familia, said that if EPTC subsidies – or the state-funded versions of them – eventually disappear, the proportion of uninsured or under-insured patients would likely increase, leaving the clinic network to absorb the costs of providing uncompensated care.
“When you are looking at an organization like ours, potential impact could be devastating,” he said. “That impact will translate to lack of patient care.”
As uncompensated care costs rise for organizations like La Clinica, they must trim costs, such as by cutting services or closing clinics. The delay in patient care provided by clinics then could cause people to skip out or delay care, which in turn will result in a sicker population as time progresses, Medina said.
“That’s a huge concern for this organization,” Medina said. “It means when these patients do show up at our doors at a community health center, you are going to see a more complex patient, which makes it hard for our doctors to provide the care that the patients need.”
Check coverage options at BeWell NM
Sanchez said BeWell NM encouraged residents who are facing premium hikes to visit BeWell NM during open enrollment, through Jan.15, to see if there is a plan that fits their needs and budget better.
“BeWell is a trusted source, and we can do the work for you for free,” she said. “You can get connected to a certified assister. This is somebody who has been trained and they can go over your options to help you fill out the application.”
A person’s household size, zip code and household income all factor into the subsidy levels that could be available to them.
Continued Sanchez: “I would really encourage that people contact us and get a certified assister.”
Appointments can be made at BeWellNM.com, where people can schedule appointments with an assister in their area.
Elva K. Österreich is a freelance journalist working with the Southern New Mexico Journalism Collaborative. For more info, visit www.southNMnews.org.
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I subscribed to the “Reader” in order to keep updated on local Cloudcroft news NOT for political stories like this. We know who Elva K. Österreich is. We don’t need her here. We know where to find her opinions if we want them. Your readers are likely more conservative than the New Mexicans who live north of I-40. You may want to keep that in mind. Gary Wood nearly ruined the old Cloudcroft monthly newspaper with his liberal rantings. Is that what you’re turning this into?