by Mónica Rae Otero, LMSW
Policy Analyst
April 14, 2026

Expanding access to health care for New Mexicans is multifaceted and complex. This legislative session, New Mexico made major investments to help keep health care accessible and affordable, protect families from harmful federal policy changes, and make our state a more attractive place for health care providers to practice. 

Since the passage of the One Big Beautiful Bill Act (OBBBA) in July 2025, state lawmakers and Governor Michelle Lujan Grisham have taken action during two special sessions to protect families from sharp Affordable Care Act Marketplace premium increases and Medicaid eligibility restrictions.

In the 2026 regular session, lawmakers built on these policies and worked to ensure our state health care system has the resources and structure it needs to continue offering affordable, high quality health care to all our families and children.

One key step was the passage of HB 4, which increases the distribution to the Healthcare Affordability Fund (HCAF) over the next three years. This will increase the funds available to help keep Marketplace coverage costs low, despite the federal government failing to extend Enhanced Premium Tax Credits (EPTCs) at the start of the year. 

Additionally, lawmakers included strong funding protections in HB 2, the budget bill, to ensure affordable health care coverage for New Mexicans through special appropriations from the HCAF, including:

  • $30 million for Medicaid expansion population coverage
  • $25 million toward BeWell premium assistance, to prevent coverage loss for individuals and families earning under 400% of the federal poverty level (FPL), or about $132,000 annually for a family of four 
  • $38.1 million to continue to offset the expiration of EPTCs for those earning above the 400% of the FPL  
  • $40 million for immigrant Medicaid enrollees who would otherwise lose eligibility on October 1, 2026

In addition to these affordability and coverage protections, lawmakers made progress on improving the health care workforce landscape in our state. After several years of work, New Mexico passed the SB 1, Interstate Medical Licensure Compact Act, and HB 50, Social Work Licensure Interstate Compact. These compacts will make it easier for physicians and social workers from other states to provide telehealth services and practice in New Mexico. While this is not the end all be all, this is an important step in addressing provider shortages and expanding access to care.  

These policy wins were a huge step towards a robust and inclusive health care system, but New Mexico must continue to look ahead and plan for the federal health care changes on the horizon. Later this year, our state will start to feel the full impacts of the OBBBA, including the loss of Medicaid coverage for refugees and asylees in October, the implementation of biannual Medicaid eligibility checks in December, and harsh new Medicaid work requirements in January 2027. These changes are expected to create significant coverage losses and financial strain for families across the country.

While the 2026 legislative session was a strong step forward for health care access and affordability, New Mexico lawmakers and the Health Care Authority must continue to prepare for these federal changes as soon as possible, before our families and children lose access to the health care services they need to thrive.