OPINION: Reform is a responsibility, not a one-time victory

New Mexico has taken an important step toward protecting health care access by delivering House Bill 99 to the governor’s desk. That achievement deserves recognition. Yet during the often-combative debate, House Speaker Javier Martínez suggested that the very need for medical malpractice reform envisioned in HB 99 had signaled failure — that we are yet again revisiting a problem addressed in 2021 and 2023. His frustration is understandable. But it overlooks a hard truth: The most complex policy challenges — especially safeguarding access to care — are never permanently “fixed.” They must be managed, measured and recalibrated as conditions change.

Malpractice law is no exception.

HB 99 was a heavy lift. Rep. Christine Chandler, D-Los Alamos, joined by Rep. Gail Armstrong, R-Magdalena, Sen. Crystal Brantley, R-Elephant Butte, and others, pushed meaningful reform across the finish line despite fierce opposition from a deeply entrenched trial attorneys’ lobby and powerful members of the Senate Judiciary Committee, where past reform efforts have stalled. Their work required persistence and political courage. Most importantly, they kept the focus where it belongs — on ensuring that New Mexicans can find a doctor when they need one.

HB 99 brings hope for greater predictability to a malpractice environment that has driven physicians from our state and discouraged new doctors from coming. But let’s be clear: It is not a cure-all. We may not know its full impact for years. Meanwhile, the health care landscape continues to shift. Corporate consolidation, workforce shortages, rising insurance costs and evolving litigation strategies all shape whether physicians choose to practice here.

One of the most destabilizing trends has been the near-automatic pleading of punitive damages. In recent years, punitive claims — alleging reckless or even “evil mind” conduct— have appeared in roughly 92% of malpractice cases, regardless of merit. These damages are not covered by a physician’s malpractice insurance. Even when such claims ultimately fail, their mere presence threatens physicians’ personal assets and pressures early settlement. The result has been higher premiums, diverted resources and growing instability, particularly in rural communities already struggling to recruit providers.

HB 99 is designed to narrow that exposure and restore balance. If it works as intended, it will reduce incentives for spurious punitive claims, stabilize premiums and signal to physicians that New Mexico is serious about creating a sustainable practice environment. That signal matters. Recruitment and retention are not abstract policy goals; they determine whether families all over New Mexico can access timely care.

But hope is not a strategy. Markets adapt. Legal tactics evolve. Political winds shift. Declaring the issue “fixed” risks complacency at precisely the moment vigilance is required. Reform must be treated as an ongoing responsibility, not a one-time victory.

Regardless of the upcoming 2026 House or gubernatorial races, those committed to health care access are vowing to remain engaged through the interim and into the 2027 session. Malpractice reform is foundational, but it is only one piece of a larger puzzle that includes provider accountability, reimbursement reform, rural infrastructure and investment in graduate medical education.

As a member of the physician leadership community, I believe we must approach this work with discipline and intellectual honesty — not as a contest of rhetoric, but as a shared responsibility. We can protect the rights of injured patients while also ensuring that our legal climate does not erode access for everyone else.

New Mexico cannot afford another cycle of crisis. Reform is not a destination. It is continuous journey.

Dr. Mark Epstein is a New Mexico-based health care advisor and board member of various health care organizations.