OPINION: Doing right by Americans in uniform

In February 2018, the secretaries of the Navy, Army and Air Force sent a joint letter to all U.S. governors, urging them to enhance state support for military families, especially in areas affecting their quality of life during relocations. Among their top concerns was access to medical care. Representing the interests of 2.4 million service members, these senior leaders called on states to prioritize robust health care accessibility for military personnel and their families.

New Mexico has struggled with a critical shortage of doctors for many years. By 2021, data showed that four out of five counties in the state fell short of the recommended 8.5 primary care practitioners for every 10,000 residents. The Cicero Institute further highlighted the severity of the problem, identifying 32 out of 33 counties as being in urgent need of primary care physicians — with only Los Alamos County meeting the necessary benchmark.

The situation worsened in 2021 when the state Legislature enacted some of the nation’s highest malpractice caps, increasing potential liabilities for hospitals and independent practices nearly tenfold. This legislative change caused malpractice insurance premiums for physicians to skyrocket — doubling, tripling or even quadrupling in some cases. The dramatic rise in both the frequency and magnitude of malpractice settlements has made practicing medicine in New Mexico an increasingly risky proposition for many doctors.

By 2025, eight years after the service secretaries’ call to action, New Mexico’s physician shortage remains a major barrier to health care access for both residents and military families relocating to the state. The heightened financial and legal uncertainties have led many physicians to reconsider their commitment to practicing in New Mexico, with some choosing to leave or retire early. This trend has resulted in longer wait times for appointments and diminished access to specialized medical services, further straining the health care system.

The most effective and immediate step New Mexico can take to address its physician shortage is to join the Interstate Medical Licensure Compact (IMLC). Similar in spirit to the Uniform Commercial Code, professional licensure compacts like the IMLC streamline the process for qualifying physicians to obtain licenses and practice across state lines. This not only facilitates cross-state telemedicine without legal obstacles but also enables rapid responses to medical crises by reducing bureaucratic delays. Importantly, the IMLC maintains high professional standards rather than lowering them.

The compact is a proven solution: More than 40 states — including all of New Mexico’s neighbors (Arizona, Colorado, Oklahoma, Texas and Utah) — have already joined. Many physicians who have left New Mexico have relocated to these states, drawn by more favorable legal and professional environments.

For several years, the Kirtland Partnership Committee has championed legislation to enable New Mexico to join the IMLC. However, these efforts have faced resistance from supporters of the 2021 malpractice caps, which many see as unreasonably high. On the opposing side is the group New Mexico Safety Over Profits, whose primary donors are plaintiff attorneys and law firms that collect significant portions of jury awards. This ongoing debate has hindered progress on health care reform.

New Mexico derives significant economic benefits from its military community. In the previous year alone, Kirtland Air Force Base contributed $7.5 billion to the state’s economy. Military leaders consider health care access a crucial factor when selecting locations for operations. Currently, it is estimated that 1 in 4 planned military transfers to New Mexico does not take place due to concerns about inadequate health care. All three New Mexico bases are in the Air Force’s top 15 highest rejection rate of “Dependent Travel not Advised” based on the medical specialty care available in the state. Addressing the 2018 request from military service secretaries is therefore essential for both the state’s economic future and national security interests.

The 2021 malpractice statute has also created challenges for recruitment at premier research institutions such as Los Alamos National Laboratory and Sandia National Laboratories, as well as in the private high-wage technology sector — all of which rely on accessible, high-quality health care to attract talent.

New Mexico’s experience with the National Nurse Licensure Compact, which the state joined in 2003, demonstrates the value of professional licensure compacts. In some communities, up to 80% of available nurses are present because of this compact. While joining the IMLC will not resolve every health care challenge the state faces, it represents the most practical, reasonable and cost-effective approach to expanding New Mexico’s physician workforce and improving health care access for all residents.