New Mexico’s relatively high rate of emergency department visits for routine health care could be a sign of a lack of access to primary care, according to a Legislative Finance Committee report. (Photo by Shelby Wyatt for Source NM)
Even though state lawmakers have allocated billions of dollars in the last few years to improve access to health care, New Mexicans’ physical and mental health outcomes have remained the same or worsened, health officials and legislative analysts say.
A higher proportion of New Mexicans of all ages had substance use disorders in 2024 compared to the prior year, and more young people had major depressive episodes, according to data cited in a presentation by Legislative Finance Committee Analyst Eric Chenier and New Mexico Health Care Authority Secretary Kari Armijo.
While fewer women in New Mexico are dying during or shortly after pregnancy, more children are being born with low birth weights and withdrawal symptoms from being exposed to drugs while in the womb, according to data cited in the presentation.
As for access, fewer people are actually going to doctors’ offices than before the COVID-19 pandemic, but more people are seeing mental health practitioners, the data show. The report notes that it relies on utilization data that only shows if providers billed for more services, not necessarily if more Medicaid patients are receiving care.
New Mexico ranks 16th in access to behavioral health care overall, Armijo told the Legislative Finance Committee at its meeting in Taos on Wednesday.
“We’re not at the top, but it shows the interventions are working,” she said. “The state has really done a lot of work to rebuild the behavioral health system. We’re struggling with a new set of issues, in many ways, that weren’t present a decade ago.”
Medicaid
The New Mexico Medicaid program operates as the largest payer of health insurance in the state, covering approximately a third of the state’s population, Armijo said.
According to the presentation, Medicaid is “the greatest lever available to the state to reduce the prevalence of mental illness and substance use disorders and improve physical health for women and children.”
Approximately 4,000 new health care providers have joined the Medicaid network in the last 11 months, Armijo said. Of those, 57% work as behavioral health providers and 29% are in primary care, she said.
Lawmakers most recently increased provider reimbursement rates to 137% of the rate paid by Medicaid, Armijo said.
New Mexico has paid out $2.2 billion in reimbursements to health care providers, Chenier said, including $1.3 billion to hospitals and $90 million to behavioral health providers.
New Mexico has put approximately $550 million in one-time funding for behavioral health services, LFC Analyst Eric Chenier said.
Armijo said the Medicaid unwinding at the end of the public health emergency for COVID-19 resulted in the number of people enrolled in the program to drop from more than 1 million to approximately 839,000. She said the rolls are “leveling off” and are not growing.
Less than 5% of New Mexicans who lost Medicaid during ‘unwinding’ switched to private insurance
Primary care
Primary care is an entry point for behavioral health because it is the most likely setting where someone will actually receive behavioral health services, Armijo said. Primary care providers can prescribe medication-assisted treatment for substance use disorder, for example.
Among all U.S. states, New Mexico ranks 29th in access for primary care services, according to data in the presentation.
“It’s not where we want to be, but [it’s] not the worst,” Armijo said.
The network of primary care providers has grown every year, Armijo said, and nearly every provider in the state received a raise because of lawmakers’ reimbursement rate increase that went into effect in January.
For future discussions, Sen. Michael Padilla (D-Albuquerque) asked about a way to gather data on how long it takes for new patients to see a primary care provider versus existing patients, and how that breaks down between urban and rural parts of New Mexico.
How the ‘one big beautiful bill’ could play out
Because of Medicaid’s outsized influence in New Mexico’s health insurance market, the federal tax and spending legislation under consideration by Congress would impact not only Medicaid recipients but all New Mexicans, Armijo said.
New Mexico would lose $2.8 billion in federal medicaid funding under the reconciliation bill, she said.
The legislation would result in 111 health care providers losing funding, Armijo said, and the potential closure of between six and eight rural hospitals.
Almost 90,000 people would lose Medicaid because of work requirements and other requirements proposed in the bill, she said.
People on Medicaid are often working a minimum wage job, she said, while others are elderly or disabled who can’t just go out and find work.
“When you have people who are working, and new work requirements, you have to be very careful about how you’re administering that: You don’t want people losing it because of administrative hassle,” Armijo said. “Work requirements can be confusing to comply with.”
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