New Mexico's stance on medical compacts could hamstring its bid for federal health funds

SANTA FE — New Mexico’s application for a slice of a $50 billion federal rural health fund could be hampered by the state’s isolationist approach to out-of-state health care providers.

The U.S. Health and Human Services Department this week announced the application requirements for states to follow in requesting money from the fund, which was approved as part of the One Big Beautiful Bill signed by President Donald Trump in July.

Among the criteria the federal government will use to score states’ applications is whether states are members of interstate medical compacts for doctors, nurses, psychologists, physician assistants and emergency responders.

The compacts allow doctors and specialists to treat patients who live in other states via the use of telehealth or in-person visits.

“By providing clinicians with the opportunity to serve patients across state borders, licensure compacts increase the supply of accessible rural health providers,” the application released by the federal Centers for Medicare and Medicaid Services states. “This also increases the reach and effectiveness of telehealth in enhancing rural access.”

However, New Mexico is currently only a member of one such compact — the one for nurses — and legislation approving the state’s membership in other compacts stalled in the state Senate during this year’s 60-day legislative session due to some senators’ concerns about legal sovereignty.

As a result, the state’s application for federal funding could be docked by federal officials, which some advocates say could in turn lead to a smaller ultimate award amount.

Fred Nathan, the executive director of the Santa Fe-based Think New Mexico, which has pushed for New Mexico to join additional medical compacts, said the award criteria gives more urgency to the matter since state applications are due by Nov. 5.

He urged Gov. Michelle Lujan Grisham to reconsider adding the medical compacts to the agenda of a special legislative session the governor recently announced.

“Legislative leaders have an opportunity to maximize federal support for New Mexico’s rural hospitals by working with the governor to include the health care worker compacts on the agenda for the special session that starts Oct. 1,” Nathan said Friday.

Lujan Grisham recently said she initially wanted to include the medical compacts on the special session agenda, along with several other issues, but agreed to delay the issue until the 30-day session that starts in January after discussions with top Democratic lawmakers.

As part of that agreement, leading legislators agreed to fast-track such bills to the governor’s desk once the regular session gets underway.

New Mexico Health Care Authority officials said in July the state was planning to apply for money from the rural health fund. At the time, the agency projected the state could receive at least $175 million annually over a five-year period if its application were to be approved.

An agency spokeswoman said Friday the Health Care Authority plans to hire an outside contractor to assist with the state’s application, adding that an open bidding process for the contract has already been undertaken.

In addition, Health Care Authority spokeswoman Marina Piña said the agency is reviewing the scoring criteria set by the federal government.

Piña did not specifically address the issue of the medical compacts, but said there are “several state policy options” that could affect scoring.

Money distributed from the rural health care fund could at least partially offset projected spending cuts from the federal budget bill that are expected to hit New Mexico particularly hard and potentially close at least six rural hospitals if help is not found.

The state had about 807,000 people enrolled in Medicaid as of August — or roughly 38.1% of the state’s total population, according to HCA data. That rate is among the highest in the nation.

Final funding awards from the rural health care fund are scheduled to be announced by the end of this year.