Dennis Domrzalski, Reporter- Albuquerque Business First
Though many Americans decry the possibility of a single-payer health care system, in which the government pays the bill, in New Mexico that system is pretty much here, according to financial reports filed with the New Mexico Office of the Superintendent of Insurance.
In 2013, only 13.5 percent of the $2.23 billion in health care premiums collected by the three insurers that file financial reports with the state were from commercial or private payers, according to the reports. The other 86.5 percent of those premiums came from government programs – Medicaid, Medicare and the Federal Employees Health Benefits Plan – according to the reports.
One health insurance executive said the federal government will be an even larger health care player in the near future as more than 70 million baby boomers transition onto the federal Medicare program.
“In five to ten years from now, the feds and the state will have something to do with more than 80 percent of revenue for any hospital,” said Stephen Forney, vice president and CFO of Lovelace Health System. “And the commercial book of insurance business where an employer goes out and buys a plan for its employees, or where an individual buys a plan that is not subsidized, it is going to be a dwindling number over time. As the baby boomers slip into Medicare, that is going to accelerate.”
In 2013, Presbyterian Health Plan collected $1.14 billion in premium revenue, according to its year-end financial report with the OSI. Of that, $223.7 million, or 19.6 percent, was commercial business. The rest came from Medicare, Medicaid and the FEHBP.
Lovelace Health Plan collected $615 million in premiums during the year, $79.5 million, or 12.9 percent of which was commercial business, its report said. Eighty-seven percent of the health plan’s premium revenue came from government programs.
Molina Healthcare of New Mexico collected $490.6 million in premiums, all of which was from government programs.
The figures from the three health plans present an incomplete picture because other insurers that sell in the state are owned by out-of-state companies that don’t report their New Mexico figures. Blue Cross and Blue Shield of New Mexico, for example, insures more than 400,000 state residents but is owned by Illinois-based Healthcare Service Corp. HSC owns Blue Cross plans in Illinois, Oklahoma, Montana, New Mexico and Texas. It files a combined financial report in Illinois.
As of March, 603,000 New Mexicans were enrolled in Medicaid, a joint federal-state program for low-income children and adults.