Last updated: October 22, 2025
For media requests and general inquiries: Alex McCausland, Communications Manager, media@nmvoices.org
Download a month-by-month PDF here. (September 22, 2025; 12 pages)

Now that the One Big Beautiful Bill Act (OBBBA) has been signed into law, New Mexico lawmakers will be forced to defend against cuts to the income support programs that lift many of our families and children out of deep poverty. Below is a timeline of the policy changes that will impact New Mexico’s health care and food assistance programs.

  • Rural Health Transformation Program grants become available for the next five years. This will be before most of the health care cuts take effect, and will only offset 37% of the estimated total for national cuts rural communities will face over the next 10 years.
    • Impact on New Mexico: The Centers for Medicare and Medicaid Services (CMS) has broad discretion over how to distribute the grants, and may approve or deny applications without administrative or judicial review. As a result, New Mexico could receive at least $100M per year for five years, or it may not receive any funds based on CMS’s independent evaluation.
  • New Mexico held a special legislative session to allocate funding to address imminent federal cuts and policy changes. Three of the five bills passed provided health care and food assistance support in direct response to the immediate and near-term harms of the OBBBA, such as:
    • HB 1 – General Appropriations
      • $110 million allocated to address upcoming changes to Medicaid, SNAP, and Marketplace insurance plans, as well as funds to prevent provider and hospital closures
    • HB 2 – Health Care Coverage Changes
      • Gives the state more flexibility to use the Health Care Affordability Fund to:
        • cover expiring health insurance tax credits for households earning over 400% of the federal poverty level; and
        • cover portions of premium costs for immigrants that lost eligibility for Enhanced Premium Tax Credits (EPTCs).
    • SB 1 – Health Care Grants and Stabilization
      • Gives the state more flexibility to use the Rural Health Care Delivery Fund to:
        • include health care providers located in “high-needs geographic health professional shortage area[s],” and tribally operated healthcare facilities; and
        • to use funding to support existing services at risk of reduction due to lost revenue.

  • Expanded SNAP work requirements impacting parents of teens, older adults, people experiencing homelessness, veterans, and former foster youth take effect on November 1. New Mexico will also no longer be eligible for waivers based on unemployment rates, except for SNAP participants in Luna County, on November 2.
  • Open enrollment period for Marketplace health insurance (BeWell in New Mexico) begins on November 1.
  • Applications for the federal Rural Health Transformation Program are due by November 5.

  • By December 31, the Centers for Medicare & Medicaid Services must make a decision to approve or deny states’ applications for the Rural Health Transformation Program.

  • Most categories of immigrants with lawful status lose access to Medicaid.
  • New Mexico’s portion of administrative costs for SNAP increases to 75%.

  • Medicaid eligibility checks are increased to every six months instead of once a year. Additional paperwork and bureaucracy will cause many to lose health insurance coverage.
    • Impact on New Mexico:  Increased eligibility checks will lead to higher enrollment drop-off during the eligibility verification process.

  • Work requirements for people receiving Medicaid under the eligibility expansion go into effect, although the U.S. Health and Human Services secretary can delay implementation until the end of 2028. Individuals ages 19 to 64 must report 80 hours of work or other “community engagement activities” (or receive a qualifying exemption) to maintain eligibility.

  • Reduction in provider taxes begins, decreasing from 6% to 3.5% by 2032.
    • Impact on New Mexico: Provider tax revenue funds New Mexico’s portion of directed payments for hospitals.
  • States must pay a share of SNAP benefits based on benefit error rates. Implementation will be delayed until October 2028 or 2029 for the states with the highest error rates in October 2027.

  • Phase down of state-directed payment rates begins. State-directed payments help boost payment rates for providers that accept Medicaid reimbursement, and prevent hospital closures.
    • Impact on New Mexico: This phase down, in conjunction with reduced provider rates, could mean the closure of 6-8 New Mexico hospitals. As a result, rural communities in New Mexico will have to travel further for life-saving care.
    • Actions taken: During the 2025 special session, one bill passed to prevent the harmful impacts of this policy change on New Mexico’s health care system. SB 1 allows the state to use the Rural Health Care Delivery Fund to support health care providers located in “high-needs geographic health professional shortage area[s],” and tribally operated healthcare facilities.

  • Cost sharing for people with Medicaid coverage who are part of the expansion population (i.e., have incomes above 100% of the federal poverty level) take effect, and states may allow providers to deny services to those who cannot pay the required co-payments for care.