New Federal Changes - BeWell, New Mexico's Health Insurance Marketplace

If you have heard of Congress’ One Big, Beautiful Bill, you may have questions about how it affects you and your health insurance. A federal agency called the Centers for Medicare and Medicaid Services (CMS) oversees marketplaces like BeWell, and it also recently finalized a new rule that made some major changes that impact some consumers’ eligibility for coverage and subsidies. Below we break down the federal changes and what they mean for you.

October 2025 changes

During an October special legislative session called by Governor Michelle Lujan Grisham, New Mexico lawmakers passed the following legislation for a 6-month temporary fix.

If you are getting federal subsidies now, and they are set to expire in 2025, you will have your savings covered by the State of New Mexico. Connect with a certified assister who can answer your questions for free.
Allows New Mexicans with incomes over 400% of the federal poverty level (FPL) to receive New Mexico Premium Assistance to backfill the loss of enhanced premium tax credits (EPTC) if the federal credits expire at the end of the year.
Those under 400% had previously been identified to also have their savings covered from federal losses.

If the State does not renew these savings and Congress fails to extend tax credits, many customers will see premium increases ranging hundreds of dollars. Examples are below:

Based on a recent analysis performed by Consumer Checkbook for the Office of Superintendent of Insurance, the following scenarios illustrate net premium changes for New Mexicans if the New Mexico Premium Assistance program was not available to replace the enhanced APTC that is set to expire at the end of this year.

Example 1: Household with income under 200% of the federal poverty level

A 27-year-old man making $28,953 (185% FPL) living in Los Lunas (Valencia County) can choose Turquoise plans for $0 premium. Without the additional state assistance that replaces the enhanced PTCs, his Turquoise plan would cost $142/month.

Example 2: Household with income between 200% and 300% of the federal poverty level

A couple living in Hillsboro NM, ages 63 and 60, with income of $49,700 (235% FPL) can choose two Turquoise plans for $0 net premium. Other Turquoise plans available cost $4/month and $96/month respectively.

Without the NM Premium Assistance program (i.e. just the 2026 ACA federal subsidies) there would still be two Turquoise/Gold plans available for $0 in Plan Year 2026; however, the lowest cost plan from another insurer would now be $271 rather than $0/month.

Example 3: A three-person household, making $81,333 (315% FPL), in:

Carlsbad can choose Turquoise plans for $0. Without the additional state assistance that replaces the enhanced PTCs, their Turquoise plan would cost $301/month.

Santa Fe can choose Turquoise plans for $172/month. Without the additional state assistance that replaces the enhanced PTCs, their Turquoise plan would cost $482/month.

Albuquerque can choose Turquoise plans for $249/month. Without the additional state assistance that replaces the enhanced PTCs, their Turquoise plan would cost $559/month.

Example 4: A four-person household, making $130,207 (405% FPL), in:

Las Cruces can choose Gold Plans for $280/month. Without the additional state assistance that replaces the enhanced PTCs, their Gold plan would cost $1,597/month.
Farmington can choose Gold plans for $236/month. Without the additional state assistance that replaces the enhanced PTCs, their Gold plan would cost $1,630/month.
Albuquerque can choose Gold plans for $730/month. Without the additional state assistance that replaces the enhanced PTCs, their Gold plan would cost $1,516/month.

State and federal premium assistance amounts are subject to change. BeWell will notify customers and we strongly suggest you connect with a certified assister for personalized help.

KFF and HCA have created a calculator that allows you to enter your income, family size, and location to estimate what your 2026 premiums would be with and without the recent increase in state subsidies to offset reductions in federal assistance.

Note: The tool only provides an estimate and does not represent an official eligibility determination. Members of federally recognized tribes may also qualify for additional benefits. Visit enroll.bewellnm.com for a full eligibility determination.

Other Federal Changes

Deferred Action for Childhood Arrivals (DACA)

The federal government has determined DACA recipients are no longer eligible for coverage through BeWell. The New Mexico Health Care Authority has instituted the DACA Coverage Bridge Initiative to help DACA recipients stay covered.
All current DACA enrollees will see their coverage end on October 1, 2025.

Low-income individuals and households

The federal government has removed New Mexico’s special enrollment period for those with household income up to 200% of the federal poverty level (about $62,400 per year for a family of four).

Have you had other life changes? You may qualify to enroll outside of open enrollment through a different qualifying life event. Learn more on what qualifies here.

Restrictions on savings for some customers

The federal law changes who is eligible for cost savings through marketplaces like BeWell.

People who are ineligible for Medicaid due to their immigration status and the five-year bar will no longer be eligible for APTC if their income is below 100% FPL starting in plan year 2026.
- The State of New Mexico is covering APCT costs until July of 2026.

For people who are not U.S. citizens, only people who qualify as “eligible aliens” will qualify for APTC, Cost-Sharing Reductions and other savings starting in plan year 2027.

- All “eligible aliens” will need to show proof of immigration status to qualify.

- Some lawfully present individuals who receive these savings now may no longer be eligible starting in plan year 2027.

Open enrollment date changes for plan year 2027

The open enrollment period for plan year 2027 will be shorter.

The federal government is changing open enrollment dates to last Nov. 1, 2026, to Dec. 31, 2026.

Open enrollment dates for plan year 2026 will be Nov. 1, 2025, to Jan. 15, 2026.

Losing Medicaid

The federal government has made significant changes to Medicaid, including eligibility and work requirements. These changes will not impact this year.

If you have questions about your Medicaid coverage, please contact the Health Care Authority.
The New Mexico Health Care Authority has its own federal changes webpage that you can check for updates.