Las Cruces panel warns of 'Big Beautiful Bill's cuts to health care

LAS CRUCES — A panel of community advocates and a physician sounded an alarm Friday over how New Mexico's health care system will be affected once changes enacted under the federal reconciliation law, known as H.R. 1 or the "One Big Beautiful Bill" signed by President Donald Trump in July, take effect in January.

At the end of this year, federal enhanced premium tax credits enacted in 2021, which lowered the cost of health insurance purchased through the state's Affordable Care Act exchange (known as BeWell) will expire.

Victoria Hernandez, an outreach specialist with BeWell, said 88% of the state's enrollees benefit from those credits. She said the loss of those credits, coupled with increases to the costs of plans averaging nearly 36%, means premiums will jump in cost, potentially stripping coverage from many New Mexican households.

U.S. Sen. Martin Heinrich, D-N.M., hosted the panel during a second day of appearances in Las Cruces, where he toured university research facilities and held roundtable discussions about H.R. 1's cuts to Medicaid and food assistance.

"If there's one shared value across different political perspectives, it's that we want higher labor force participation," Heinrich said, "but the irony is, if you make it so hard to get health care, then that actually keeps people from working; and we see labor participation go down even though the stated goal is to make it go up."

The loss of health insurance purchased through the state exchange, on top of reduced reimbursements from Medicaid, would heap pressure on clinics, hospitals and community health organizations like La Clinica de Familia, whose chief medical officer, Dr. John Andazola, sat on the panel.

Andazola said the rate of patients delaying care until it was too late, relying on emergency rooms for medical intervention, could rise along with uninsured rates to pre-ACA levels: "I remember seeing patients with advanced cancers. I remember seeing patients with renal failure. I remember seeing patients with advanced disease … and I’m going to see that again."

Arika Sánchez, the New Mexico Center for Law and Poverty's policy director, called on state lawmakers to cushion the projected impact of the federal law during the special session that is set to begin Wednesday.

Steps her organization recommends include subsidizing premiums for residents who lose federal tax credits through the state's Healthcare Affordability Fund; increasing revenue distributed through the fund to help cover people; ensure coverage for immigrants who will be locked out of the BeWell exchange beginning in January; and to plan for supporting clinics and providers serving low-income and uninsured patients.

Yet Heinrich warned the cost of Medicaid cuts alone to New Mexico were projected to be $4 billion annually — more than a third of the state's nearly $11 billion budget for 2026. "The amount of money that they can afford to put in that fund just pales in comparison to the scale of what we're talking about here," he said.

Lawmakers return to Santa Fe on Oct. 1 for the special session called by Gov. Michelle Lujan Grisham to address federal cuts to Medicaid and SNAP as well as public broadcasting. Republican lawmakers, who hold minorities in both chambers, have argued that H.R. 1's effects are "highly complex" and that residents might not be affected until 2027, leaving the state ample time to plan ahead.

Republican leadership in the state House and Senate has called for the special session's agenda to focus on crime, medical malpractice laws, and the state’s beleaguered Children, Youth and Families Department.

"The people of New Mexico are convinced these are the real emergencies facing our state," they wrote.