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NM overhauling state insurance regulation

Associated Press Published: November 24, 2012

The state also must decide whether to expand eligibility of Medicaid to potentially provide health care to nearly 170,000 low-income residents by 2020.

"This is going to be a huge jump in what we're doing and how we're insuring everybody," said Insurance Superintendent John Franchini, who was selected by the PRC in 2010 to run the commission's Insurance Division.

The regulator will oversee rates for health plans offered through the exchange just as it now approves the pricing of policies offered by insurance companies doing business in New Mexico.

"That's our big responsibility to make sure the policies are fair, the coverages are there and the injured parties get the benefits that they deserve from the policies they paid for, and the insurance companies are financially strong enough that they have to be able to pay these claims," Franchini said in a recent interview. "That's not going to change when there is an exchange."

He said the Insurance Division plans to speed up regulatory decision-making by completing its review of rates and insurance forms within 30 days after companies submit them to the agency. Currently, the regulator can take 60 days.

Franchini said he doesn't want insurance regulation to create problems for the state in implementing provisions of the federal Affordable Care Act, which is to provide more protections to people who already have health insurance as well as expand access to those without medical coverage.

"Between 2014 and 2017, we're going to have a lot of stress in the system. Through the market processes we can put in, at least we'll take the regulatory stress off. We're not going to be a stumbling block in the process," said Franchini.


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