State report shows how Medicaid Forward will lower healthcare costs, expand access to coverage, and drive long-term savings for families, providers, and the state
Santa Fe, NM – Yesterday, Incoming House Majority Leader Reena Szczepanski, healthcare providers, and advocates from the New Mexico Together for Healthcare coalition presented key findings from the newly released Health Care Authority (HCA) report on Medicaid Forward to the Legislative Health and Human Services (LHHS) Committee. This landmark proposal would eliminate income limits for Medicaid eligibility, cap healthcare spending at just 5% of household income, and provide affordable coverage for nearly all New Mexicans, resulting in lower costs, better access, and substantial long-term savings for the state.
As directed by House Bill 400 (2023), the HCA’s study models several program options, with the most expansive design closely aligning with community and provider priorities. This model would not only eliminate income eligibility limits but introduce a sliding-scale cost-sharing structure. This model is projected to cover over 60% of uninsured New Mexicans, deliver millions in savings to families, and result in net savings for the state. A bill for the full implementation of Medicaid Forward will be introduced in the 2025 Legislative Session.
Key Takeaways from the HCA Report:
- Affordable coverage and savings: Medicaid Forward will dramatically lower the cost of healthcare for New Mexico families. For example, a family of four earning $124,800 annually would pay only $6,240 per year under Medicaid Forward, compared to more than $24,000 under other plans. This translates into real savings for families, with the added benefit of predictable, lower healthcare costs.
- Health and dignity for all: Medicaid Forward supports the core belief that healthcare is a right, not a privilege. It ensures that healthcare is affordable and accessible to every New Mexican, regardless of income. By covering more people and reducing the uninsured rate by 48%, Medicaid Forward will provide health and dignity to those who have long been excluded from affordable care.
- Strengthening providers and communities: Healthcare providers are the pillars of our communities. Medicaid Forward will ensure that New Mexico’s providers are fairly compensated for their work, boosting reimbursement rates by 3.4% to alleviate the financial strain faced by hospitals, clinics, and individual providers. This is especially critical for rural and tribal communities that rely on Medicaid to stay afloat. By increasing funding for rural healthcare, Medicaid Forward will help sustain vital health services in underserved areas.
- Economic and health equity: Medicaid Forward will help reduce racial and geographic disparities by making healthcare more affordable for Black, Indigenous, Hispanic, Asian, and Native American communities. It will also support economic growth by reducing the overall cost burden on employers and employees, saving businesses $229 million annually in healthcare costs.
- A sustainable solution: The cost of implementing Medicaid Forward is projected at $581.7 million, but the state will offset these costs through long-term savings from improved health outcomes, fewer emergency room visits, and reduced uncompensated care. In fact, Medicaid Forward will bring in a net gain of $45.6 million, making it not only an equitable choice but a fiscally responsible one.
Quote from Incoming House Majority Leader Reena Szczepanski
“For too long, too many New Mexicans have been left behind by a healthcare system that’s out of reach. Medicaid Forward is a transformative solution that eliminates income eligibility limits and caps healthcare costs at 5% of income, ensuring that every New Mexican can access the care they deserve. This is about building a healthier future and relieving some of the economic stress that weighs on family budgets. With Medicaid Forward, we can strengthen our healthcare system, lower costs for families and employers and boost our economy—making New Mexico a model for the nation.”
Quote from Arika Sanchez, Healthcare Director, New Mexico Center on Law and Poverty
“All New Mexicans deserve access to healthcare, and we cannot afford to wait on taking action any longer. Two studies, both showing a massive leap in coverage, make it clear—Medicaid Forward is the bold, lasting solution New Mexico needs. With Medicaid Forward, nearly all New Mexicans could gain access to affordable coverage and the state would see a net revenue gain. By expanding coverage and raising provider reimbursements, we can ensure that all New Mexicans, no matter where they live, have access to the care they deserve. This is about health, dignity, and building a sustainable future.”
Quote from Dr. Anjali Taneja, Executive Director, Casa de Salud
“As a physician and employer, I’ve seen firsthand how the current system creates significant barriers for both patients and providers. New Mexico is losing healthcare professionals to burnout, in part because of the inability to provide high quality care when patients are uninsured or when they have very high out of pocket costs with insurance. Medicaid Forward is a creative, game-changing policy that not only addresses this issue but also strengthens our healthcare system by offering predictable and fair reimbursement. With expanded Medicaid coverage, we can continue to attract and retain providers, reducing burnout and ensuring that patients have access to essential care—without the burdens of copays, administrative hassles, or the constant worry of financial uncertainty. Many of our patients, especially those impacted by the Medicaid “unwinding” after the COVID pandemic, are being dropped from Medicaid for income changes or for administrative reasons, which only adds to the complexity and cost of seeking care. Medicaid Forward would reduce these barriers, allowing us to focus on delivering the best care possible. For small businesses like mine, Medicaid Forward is also vital to our survival and ability to serve more people. Medicaid is also a strong vehicle in New Mexico, with over 40% of adults on it, and it has oversight from the Health Care Authority, which can create and mandate certain clinical and process standards for care of New Mexicans. I urge lawmakers to prioritize this important policy in the upcoming Legislative Session—it’s a lifeline for New Mexico’s healthcare system.”
Quote from Dr. Caryn McHarney-Brown, Family Practitioner
“As a healthcare provider in rural NM for more than 30 years, I have seen firsthand that New Mexicans need an affordable, accessible, and easy to navigate healthcare system now more than ever. NM Medicaid Forward is a financially solid path to provide high-quality care for our population, adequately support our medical, dental, and behavioral health providers and staff, stabilizes funding for FQHCs allowing us to expand services and care for more people, and generate savings that New Mexico can invest in other healthcare improvements. Medicaid Forward is a creative solution for both patients and providers–easier to navigate, transportable with job changes, and provides continuous coverage for individuals across their lives. It also helps address the Medicaid ‘cliff’ and opens the door to expanding telehealth, particularly in rural areas where we struggle to retain providers. I strongly urge legislators to rally behind this initiative in the 2025 Legislative Session.”
Leroy Tso, Strong Families Community Leader in Gallup, NM
“As a resident of Toh-la-kia on the Navajo Nation, I understand firsthand the challenges of accessing healthcare in rural New Mexico. Long travel times and limited resources make it difficult for families like mine to get the care we need. Medicaid Forward is a solution that would provide affordable, comprehensive coverage. Everyone, no matter where they live, deserves the chance to be healthy and thrive—and Medicaid Forward is a step toward making that a reality for all New Mexicans.”
Lorenzo Villescas, Strong Families Community Leader in Anthony, NM
“When I was a child, my father, an immigrant farm worker, needed surgery but couldn’t afford it, and our family paid a heavy price. We had to sell his pickup truck—the only thing of value we owned—to cover the medical bills. This experience made me realize how broken our healthcare system is, especially for those without insurance. Later, when I had insurance and received immediate care for a medical emergency, I saw the difference—access to healthcare shouldn’t depend on whether you can afford insurance premiums. Now, as a community leader in Sunland Park, I’ve seen firsthand how many seniors and families still struggle with the cost of care. Medicaid Forward is a strong solution—offering affordable, reliable coverage for all New Mexicans, ensuring that no one has to sacrifice everything for their health. I urge our leaders to support this policy, which will help restore dignity and access to healthcare for families across the state.”
Robert Lopez, retired promotor and Strong Families Community Leader in Anthony, NM
“After retiring, I was deeply disturbed by the number of funerals I attended in Anthony, NM. What I learned was heartbreaking—many of my neighbors were dying from preventable illnesses simply because they couldn’t afford healthcare. Despite my efforts as a promotor to educate and connect people with resources, I realized that without insurance, even the most informed individuals couldn’t access the care they needed. That’s why I support Medicaid Forward, a plan that would allow hardworking New Mexicans to pay affordable, sliding-scale rates for the same high-quality care Medicaid has provided for years. With premiums capped at 5% of income, Medicaid Forward is a smart, cost-effective solution to a crisis that’s costing lives in our communities. No one should have to choose between their health and their livelihood. I urge our legislators to support Medicaid Forward—our people deserve better.”
Medicaid Forward Program Highlights:
- No income limit: Expands Medicaid eligibility to nearly all residents under age 65.
- Affordable sliding-scale premiums: Healthcare spending capped at just 5% of income.
- Expanded coverage: Medicaid Forward could reduce the uninsured rate by 48%, providing coverage for up to 290,000 additional New Mexicans.
- Provider support: Increases Medicaid reimbursement by 3.4% to support healthcare providers across the state, including those in rural and underserved communities.
Media Inquiries:
Following the presentation, media representatives are invited to engage with presenters to explore the impact of Medicaid Forward. Contact Paloma Mexika, Communications Director of the New Mexico Center on Law and Poverty, at paloma@nmpovertylaw.org or (505) 305-2559.
