After bipartisan talks, lawmakers could be on 'quick path' to approve compact legislation for doctors

SANTA FE — A bipartisan group of state lawmakers has been working quietly over the last several months to cook up a plan for New Mexico to join an interstate medical compact for doctors.

The negotiations could pave the way for legislation on the issue to move quickly to Gov. Michelle Lujan Grisham’s desk in the first half of the 30-day legislative session that begins next month.

"I believe we're in a really good position," said Sen. Linda Trujillo, D-Santa Fe, who was one of the six legislators involved in the working group. "I think we're on a quick path."

However, it's unclear whether bills proposing the state join other interstate compacts — dealing with physical therapists, psychologists and more — will also move quickly through the Legislature during the upcoming session.

That's because the working group was tasked specifically by legislative leaders to reach an agreement on the medical compact for doctors.

The group included three House members and three Senate members, with both Democrats and Republicans represented. They held several private meetings and reached an agreement this week, several members said.

Sen. Nicole Tobiassen, R-Albuquerque, who was also a member of the working group, said joining the compact for physicians could provide relief for military families and the state's overworked medical community.

"From what I can tell, everything is aligned," said Tobiassen, whose husband has been in intensive care for several months and is currently paralyzed due to West Nile virus. "In my mind, I see no reason why this shouldn't fly through both (legislative) chambers." 

Political pressure rising on health care issues

The interstate compacts have emerged as a hot-button political issue in New Mexico over the last year, amid growing concerns about health care access and a statewide provider shortage.

The compacts allow doctors and specialists to treat patients who live in other states via the use of telehealth or in-person visits, though specific requirements vary by compact. Advocates say joining the compacts would help alleviate a longstanding health care provider shortage in New Mexico.

The state is currently only a member of one such compact — the one for nurses — and 10 bills approving membership in compacts for doctors, counselors and physical therapists stalled in the Roundhouse during this year’s 60-day legislative session due to some lawmakers’ concerns about unintended consequences.

Since the session's end, a loose coalition of business groups and nonprofit organizations have kept up a steady drumbeat of pressure for lawmakers to approve a bevy of compact-related legislation during the upcoming 30-day session.

"There is enormous momentum growing all along the political spectrum for joining all the compacts, as so many New Mexicans cannot access healthcare providers or they have a healthcare provider, but can’t get into to see them when they need to," said Fred Nathan, the founder and executive director of the Santa Fe-based Think New Mexico, which is among the groups leading the charge on the issue.

While several members of the working group said they're hopeful agreements on other compacts can be reached, Trujillo said it can take time to work through concerns of legislators and the leaders of the compacts who ultimately decide whether new states will be admitted as members.

But she said she's optimistic a separate social worker compact bill might also win approval during the 30-day session that starts Jan. 20.

On the fast track to approval? 

Despite calls to do so, Lujan Grisham did not include the medical compacts on the agenda for two special legislative sessions she called this fall.

But the governor said she agreed to delay consideration of the compacts until the 30-day session as part of an agreement with top Democrats in the House and Senate. As part of that agreement, legislative leaders agreed to fast-track at least the medical compact bill for physicians to the governor’s desk during the session. 

Several members of the working group said that's still the plan, while adding they intend to fill in colleagues about the agreement before the session begins next month.

However, lawmakers of both political parties say joining the medical compact won't immediately solve New Mexico's health care challenges, as the state is projected to have a shortage of 2,118 doctors by 2030, according to Cicero Institute data.

Sen. Katy Duhigg, D-Albuquerque, said some supporters of the compacts have overstated the benefits of becoming a member state.

"I think a disservice has been done to the public to suggest this is a magic bullet to solve a nationwide provider shortage," said Duhigg, who cited a report suggesting New Mexico could see a 3% increase in out-of-state doctors under the health care compact for physicians.

She also said legislators involved in the working group were able to reach agreement on several amendments to the initial version of this year's compact legislation. Those changes include ensuring New Mexico laws, such as a 2023 law shielding doctors and nurses from legal liability for performing abortions and gender-affirmation surgeries, are not superseded by the interstate compacts.

"It was really important to do this work and we're in a good place," Duhigg told the Journal.

Trujillo, who is the former director of the state Regulation and Licensing Department, said the state's current exclusionary approach to interstate compacts, if left intact, could have a negative impact on New Mexico's ability to maintain its military bases and missions.

Already, concerns over the lack of specialty medical care in New Mexico have led to one out of every five airmen assigned to one of the state's three Air Force bases — Kirtland in Albuquerque, Cannon near Clovis and Holloman outside of Alamogordo — to turn down the post.

Dan Boyd covers state government and politics for the Journal in Santa Fe. Follow him on Twitter at @DanBoydNM or reach him via email at dboyd@abqjournal.com.