The New Mexico Office of the Superintendent of Insurance on Tuesday approved an average premium increase of 24.4% for plans sold through BeWell, the state’s Affordable Care Act marketplace, officials said. The adjustment takes effect Jan. 1 and is larger than the nationwide median increase of 15%.
Officials point to inflation and benefit mandates
Insurance regulators said the rise reflects broader inflationary pressure and escalating health-care costs. The office also identified the state’s comparatively broad benefit mandates — including a prohibition on requiring prior authorization for behavioral health services — as a factor in near-term premium growth.
"Rising health care costs and inflation are continuing to affect consumers nationwide and New Mexico is no different," Insurance Superintendent Alice Kane said in a statement. "Despite the rate increase, I can assure you that the rates for all the insurance companies are actuarially sound, non-discriminatory, and transparent."
Officials emphasized that New Mexico’s exchange historically has had lower premiums than the national average. A Legislative Finance Committee analysis cited by regulators found that from 2019 through 2022 the exchange’s benchmark plan ran about $100 per month below the national benchmark. Since 2023, however, state and national averages have tracked more closely, rising together from roughly $450 a month in 2023 to more than $600 in 2026.
Most enrollees receive subsidies
State officials noted that subsidies will blunt much of the out-of-pocket impact for many New Mexicans. The OSI said about 92% of the roughly 80,000 people enrolled through BeWell qualify for state or federal premium assistance based on income, which can substantially reduce the immediate cost increase for individuals and families.
- Average approved increase: 24.4% (effective Jan. 1)
- National median increase: 15%
- BeWell enrollees: ~80,000; 92% qualify for subsidies
| Metric | 2019-22 | 2023 | 2026 |
|---|---|---|---|
| Benchmark plan avg. monthly premium (approx.) | $100 below national avg. | $450 | $600+ |
What this means for consumers
For many enrollees, federal and state subsidies will offset the majority of the premium increase. But people who do not qualify for financial assistance, or who have incomes that leave them with high share of premiums relative to wages, could see a noticeable rise in monthly costs beginning in January.
Regulators said carriers’ filings were reviewed to ensure rates are actuarially justified and non-discriminatory. The OSI also argued that some state-level protections — such as the ban on prior authorization for behavioral health care — may increase premiums in the short term but are intended to improve access and reduce long-term costs and adverse outcomes.
Policy trade-offs and longer-term trends
Analysts and state lawmakers have been watching exchange costs as part of broader debates over health-care affordability and access. The Legislative Finance Committee data cited by regulators show that while New Mexico once had a sizable gap with lower premiums than the nation, that edge has largely disappeared in recent years as both state and national premiums climbed.
State and federal subsidies remain a central tool for keeping coverage affordable for low- and moderate-income households. Where those supports leave gaps, state policymakers may face pressure to consider additional measures such as premium assistance, benefit design changes, or market reforms to moderate future increases.
Enrollment for marketplace coverage typically opens in the fall; regulators and advocates advise consumers to review plan changes, check eligibility for subsidies and compare options before the new plan year begins.
This article will be updated as regulators or carriers release additional details about individual plan changes and consumer impact estimates.
