New Mexico 2025 Regular Session

New Mexico House Bill HB186 Compare Versions

Only one version of the bill is available at this time.

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28	28	HOUSE BILL 186
29	29	57
30	30	TH LEGISLATURE
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33	33	STATE
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35	35	OF
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39	39	MEXICO
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42	42	FIRST SESSION
43	43	,
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45	45	2025
46	46	INTRODUCED BY
47	47	Reena Szczepanski
48	48	AN ACT
49	49	RELATING TO HEALTH CARE; ENACTING A NEW SECTION OF THE PUBLIC
50	50	ASSISTANCE ACT TO ALLOW THE SECRETARY OF HEALTH CARE AUTHORITY
51	51	TO AMEND THE NEW MEXICO STATE MEDICAID PLAN TO CREATE A STATE-
52	52	ADMINISTERED HEALTH COVERAGE PLAN; REQUIRING COLLABORATION
53	53	BETWEEN THE HEALTH CARE AUTHORITY AND THE OFFICE OF
54	54	SUPERINTENDENT OF INSURANCE TO ENROLL INDIVIDUALS IN THE PLAN;
55	55	MAKING AN APPROPRIATION.
56	56	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
57	57	SECTION 1. A new section of the Public Assistance Act is
58	58	enacted to read:
59	59	"[NEW MATERIAL] DEVELOPMENT OF MEDICAID FORWARD PLAN.--
60	60	A. Subject to the appropriation and availability of
61	61	federal and state funds, the secretary shall:
62	62	(1) amend the New Mexico medicaid state plan
63	63	.228791.2 underscored material = new
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90	90	pursuant to the federal act to provide medical assistance by
91	91	January 1, 2028 to residents who:
92	92	(a) are under age sixty-five;
93	93	(b) are not otherwise eligible for and
94	94	enrolled in mandatory coverage or optional full medicaid
95	95	coverage under the New Mexico medicaid state plan; and
96	96	(c) have a household income that exceeds
97	97	one hundred thirty-three percent of the federal poverty level;
98	98	and
99	99	(2) in consultation with the medicaid advisory
100	100	committee and representatives of Indian nations, tribes and
101	101	pueblos that are located wholly or partially in New Mexico, and
102	102	consistent with the federal act, promulgate rules that:
103	103	(a) establish an affordability scale for
104	104	premiums and cost-sharing based on household income for
105	105	individuals eligible to enroll in the medicaid forward plan and
106	106	offer discounted premiums and cost-sharing; provided that such
107	107	financial assistance is, at a minimum, offered to individuals
108	108	with household incomes below four hundred percent of the
109	109	federal poverty level; and
110	110	(b) set the total amount of premiums to
111	111	be assessed to medicaid forward plan enrollees, after an
112	112	actuarial analysis, to ensure maximum access to coverage.
113	113	Premiums imposed may be set at a level sufficient to offset the
114	114	costs of health benefits under the medicaid forward plan and
115	115	.228791.2
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143	143	related administrative costs.
144	144	B. Consistent with the federal act and subject to
145	145	the appropriation and availability of federal and state funds,
146	146	the secretary may, in consultation with the medicaid advisory
147	147	committee and representatives of Indian nations, tribes and
148	148	pueblos that are located wholly or partially in New Mexico,
149	149	promulgate rules that phase in coverage to all individuals
150	150	described in Subsection A of this section.
151	151	C. The secretary shall consult with representatives
152	152	of Indian nations, tribes and pueblos that are located wholly
153	153	or partially in New Mexico to ensure that implementation and
154	154	expansion of the medicaid forward plan promotes effective
155	155	communication and collaboration, including information on
156	156	participation in the medicaid forward plan.
157	157	D. The secretary shall promulgate rules consistent
158	158	with and necessary to carry out the provisions of this section.
159	159	E. The secretary and the superintendent of
160	160	insurance may seek any federal waivers necessary to administer
161	161	the medicaid forward plan, provide the medicaid forward plan to
162	162	additional persons and maximize federal dollars to ensure
163	163	affordability for enrollees."
164	164	SECTION 2. A new section of the Public Assistance Act is
165	165	enacted to read:
166	166	"[NEW MATERIAL] ENROLLMENT.--
167	167	A. The secretary and superintendent of insurance
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196	196	shall coordinate efforts and cooperate with the New Mexico
197	197	health insurance exchange to establish:
198	198	(1) systems under which individuals may apply
199	199	for enrollment in, receive a determination of eligibility for
200	200	participation in and renew participation in medicaid, the
201	201	medicaid forward plan or a qualified health plan offered
202	202	through the New Mexico health insurance exchange; and
203	203	(2) consumer outreach programs to assist
204	204	individuals with enrolling in medicaid, the medicaid forward
205	205	plan and qualified health plans offered through the New Mexico
206	206	health insurance exchange.
207	207	B. The secretary, the superintendent of insurance
208	208	and the New Mexico health insurance exchange may coordinate
209	209	efforts and cooperate to make the medicaid forward plan
210	210	available for direct purchase through the New Mexico health
211	211	insurance exchange platform.
212	212	C. The secretary, the superintendent of insurance
213	213	and the New Mexico health insurance exchange shall promulgate
214	214	rules consistent with and necessary to carry out the provisions
215	215	of this section."
216	216	SECTION 3. APPROPRIATION.--Two million dollars
217	217	($2,000,000) is appropriated from the general fund to the
218	218	health care authority for expenditure in fiscal years 2026 and
219	219	2027 to hire staff and contract for consulting or technical
220	220	assistance for the development of the medicaid forward plan
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249	249	described in Section 1 of this act. Any unexpended or
250	250	unencumbered balance remaining at the end of fiscal year 2027
251	251	shall revert to the general fund.
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253	253	.228791.2