This article has been edited for clarity on Sunday, July 20, from its original online publication, on July 14.
On July 4, President Donald Trump signed into law the One Big Beautiful Bill Act, a bill that could have major impacts for the people of New Mexico.
According to a Congressional Budget Office report, changes made to Medicaid by the bill would increase the number of people without health insurance by an estimated 7.8 million by 2034. Among the changes are the creation of a work requirement for able-bodied adults under the age of 65, though concessions were made for parents of children under 14 and citizens with disabilities, according to NPR.
Some of the bill’s major items include extending tax cuts from Trump’s first term as president, which were previously due to expire at the end of the year; modifying eligibility requirements for Medicaid enrollees, changes to SNAP benefits, changes to student-loan repayment options and increased funding for border security.
According to the U.S. Department of Health and Human Services, Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. Every state runs its own program while following general rules set by the federal government.
New Mexicans rely on Medicaid at the highest rate per capita in the nation with about 40% of New Mexicans enrolled in the program. According to Source NM, estimates from the CBO predict that over 96,000 New Mexicans could lose coverage by 2030 due to eligibility changes — potentially costing the state nearly $11 billion in healthcare funding.
Alanna Dancis, the Chief Medical Officer for New Mexico’s Medicaid program, wrote a letter to the New Mexico Healthcare Authority that the work requirements would “push people off Medicaid” due to “real-world barriers” that would prevent many from qualifying or successfully obtaining coverage under the new model. Dancis used a shortage of jobs in rural areas, serving as caretakers for family members, and new reporting and verification requirements for proof of employment as examples of barriers to Medicaid.
New reporting requirements for the Affordable Care Act were also included in the bill, as well as the termination of automatic reenrollment for those receiving coverage under the marketplace program. All users will now have to submit their own paperwork — rather than the automated eligibility-checking program previously used — and reenroll every year, which could cause millions who are qualified but aren’t on top of their paperwork to lose coverage, according to PBS.
PBS also reported that legal immigrants, including asylum seekers and refugees, would no longer be allowed to purchase on those health insurance exchanges where more affordable coverage, subsidized by the federal government, is found for those who qualify.
Data from the U.S. Census Bureau estimates that the percentage of foreign-born individuals living in New Mexico is 10.2% of the state’s 2.1 million people, with 56.1% of the foreign-born individuals lacking citizenship.
A report by experts from two public health and health services centers at the University of North Carolina at Chapel Hill found that two rural hospitals in New Mexico are at significant risk of closing, out of the fifteen in the state whose funding comes primarily from Medicaid.
Chris Ramirez, Communications Director at The University of New Mexico’s Health Sciences Center, stated that while the organization was still working to understand how they would be affected by the bill, they recognize it may affect access to care, funding for clinical services, and the stability of health care delivery, particularly for at-risk populations.
Get content from The Daily Lobo delivered to your inbox
“While it is premature to speculate on the specific effects for UNM or our students and community, we expect that there will be financial challenges that will affect the ways in which we deliver education and patient care for our citizens. UNM is committed to our mission, prepared for the challenge, and ready to plan for the future of higher education and healthcare delivery,” a joint statement from UNM and UNM Hospital reads.
UNM College Democrats President Breahna Roark suggested that state lawmakers begin drafting legislation that could offer relief towards those affected by the bill financially or medically before the upcoming legislative session in January.
“It's definitely concerning, although it won't take place right now, it's something that we have to keep our eye out for the future and start putting policies and preventative attacks in place so that it doesn't completely swing our healthcare system in the next two, three years, because that's what it's looking like right now,” Roark said, citing the risk rural healthcare facilities face.
New Mexico Gov. Michelle Lujan Grisham has said she may need to call a special legislative session to address the effects that the bill may have on the state, according to Source NM.
Presbyterian Health Services provided a statement from Bill Priest, Chief Hospital Executive at Presbyterian Plains Regional Medical Center, after being asked for comment.
“With Medicaid covering more than one-third of New Mexicans, we are concerned about the impact on our state and its residents, especially in rural areas. We continue to work with our internal, state and federal partners to better understand the implications of the Medicaid cuts in the federal budget bill,” Priest wrote. “We remain committed to preparing and engaging with them to explore contingency plans and advocate for the healthcare needs of New Mexicans.”
In a statement he wrote to The Daily Lobo, State Representative John Block (R-51) claimed the bill “reins in the bloated bureaucracy that’s been draining our healthcare system for years.”
“This bill cracks down on waste, fraud, and abuse in Medicaid, restores accountability, and puts healthcare decisions back in the hands of patients and doctors, not unelected Washington bureaucrats. It sends a clear message: bigger government isn’t the solution, and H.R. 1 proves we can cut spending, protect our freedoms, and still get things done,” Block wrote.
According to CBO estimates, the bill is expected to add $2.4 trillion to the national debt by 2034.
The full impact of the bill will become present over the next few years, a UNM College Democrats statement reads.
“While from a political standpoint, H.R. 1 has the potential to fix a lot of financial national problems, in doing so, it decreases the quality of life for Americans,” the statement reads.
Elliott Wood is a beat reporter and photographer for the Daily Lobo. They can be reached at news@dailylobo.com or on X @dailylobo
