New Mexico Site Visit Report

A report funded by the Robert Wood Johnson Foundation, as part of its Affordable Care Act (ACA) Implementation-Monitoring and Tracking Series, examines New Mexico’s progress toward implementing health care reform—both the ACA and the state’s own health reforms.

New Mexico has long been recognized for its efforts to promote meaningful health reform. Prior to the Affordable Care Act (ACA), the state had already expanded Medicaid eligibility to adults without dependent children, implemented premium assistance programs for the uninsured, and established a quasi-public entity to increase access to health insurance for small businesses and the
self-employed.

Then-Governor Richardson established the New Mexico Office of Health Care Reform (OHCR) in July 2010 and charged this new office with planning, coordinating, and administering federal health reform for the state. New Mexico also received federal funding for consumer assistance and its rate review process, and began to take steps to plan for a state-based exchange using a level one exchange planning grant.

As described in this case study, exchange implementation has been a difficult undertaking, and, like most states, New Mexico has encountered both success and challenges. New Mexico has taken important steps in implementing the ACA by, i.e., designating a central state office of health care reform to coordinate the state’s reform efforts across various agencies, as well as working with both federal officials and New Mexico health care stakeholders. Despite this progress, considerable work remains. In particular, the state must designate or establish an entity to run its exchange. It is unclear whether the state will do so in the near future given the uncertainty surrounding the ACA and the Martinez administration’s ambivalence toward the law.

In addition, as of this writing in May 2012, the OHCR has yet to issue an award in response to a request for proposals for exchange information technology (IT) that was issued in February 2012. Despite this shift, New Mexico has signaled that it intends to move forward in implementing an exchange but faces many important policy decisions ahead.

This report is one of 10 state case study analyses that will be completed in 2012.