New Mexico

Status of reform effort: Legislation incorporating Governor Richardson’s universal coverage plan did not pass during the 2008 legislation session.  In August 2008, the Governor called a special session of the legislature to debate more limited health care legislation expanding coverage to children.

On October 25, 2007, Governor Bill Richardson (D) announced his “Health Solutions New Mexico Plan” to provide universal and comprehensive health care coverage to all New Mexicans.  “Health Solutions New Mexico” would create a Health Coverage Authority (HCA) that would serve as a single point of accountability for data, analysis, plan management, and policy.  The HCA would be charged with setting benefit and plan choices, affordability guidelines, and would seek ways to reduce cost and improve quality. 

“Health Solutions New Mexico” includes the following components:

• Individual mandate: As of January 1, 2010, individuals must show proof of health care coverage through commercial insurance, public program enrollment, or proof of the ability to self-fund health problems that may arise (individuals with incomes below 300% FPL would be exempt from the mandate);
• Employer Mandate: Require employers with 6 or more employees to contribute a fee per employee, with a dollar-for-dollar offset for any contribution toward employee coverage;
• Insurance Risk Pool: Create larger risk pools by expanding the New Mexico Medical Insurance Pool and by exploring other options, including allowing people to buy-in to Medicaid;
• Insurance market reforms: Require commercial health care insurers to spend at least 85 percent of premiums directly on health care; Guarantee issue without exclusion of pre-existing medical conditions;
• Require electronic claims submission and payment and the use and exchange of electronic medical records.    

The total cost and revenue for all sources will be driven by assumptions and policy decisions at the state and federal levels, including SCHIP reauthorization, people’s source of coverage, and the affordability guidelines that will be developed by the HCA.  The Health Solutions New Mexico plan was introduced in the legislature as H.B. 62. The bill was debated, but was not enacted by the legislature. Components of the reform plan may be implemented through Executive Order and may be included as 2009 budget proposals.*

*H.B. 62. 48th Legislative Session (New Mexico, 2008). For bill text see: http://legis.state.nm.us/LCS/_session.asp?chamber=H&type=++&number=62&Submit=Search&year=08.  

Updated as of 4/3/08