State must fill in healthcare gaps – By Abuko Estrada, Healthcare Director

As published in the Santa Fe New Mexican on Jan 18, 2026

Healthcare is not a privilege. It is a lifeline. 

As policymakers head to the Roundhouse this month, they must address the healthcare coverage crisis brewing in New Mexico—the effects of which will ripple through every household and community in the state. Reductions to the federal subsidies that help families afford coverage through New Mexico’s private insurance Marketplace, BeWell, are already taking effect. Other federal actions are stripping eligibility or adding red tape that will push New Mexicans off of Medicaid and BeWell coverage in the months ahead. 

These federal changes will destabilize our entire healthcare system, threaten rising healthcare costs and service reductions at our hospitals and clinics. Addressing the challenges will require decisive action from state lawmakers this legislative session. There is no single solution, but one step is paramount: making adequate and sustained state investments to keep healthcare coverage affordable and within reach for New Mexicans. 

During the October 2025 Special Session, New Mexico’s Legislature stepped up to fill in coverage gaps temporarily. However, some current budget proposals have critical gaps, leaving premiums, co-pays and deductibles unaffordable for families. Tens of thousands of New Mexicans are likely to lose their health insurance and the healthcare they depend on.

New Mexico did not choose these cuts, but the consequences will be catastrophic if the state falls short in stabilizing healthcare coverage in the face of these federal changes. For patients, coverage losses mean medications delayed or skipped, mental health care interrupted, preventive visits missed, and manageable conditions turning into emergencies. For the healthcare system, it means emergency departments used as primary care, safety net clinics stretched thinner, and longer wait times for everyone—insured and uninsured alike.

For rural and frontier New Mexico, where a clinic or hospital may be the only point of care for hundreds of miles, the potential consequences are especially dire. When coverage erodes in these communities, healthcare providers operating on thin margins face mounting uncompensated care. Critical services–labor and delivery, oncology, behavioral health–are often first on the chopping block. This instability also harms the broader economy when hospitals and clinics must freeze hiring or cannot afford to keep providers, and when workers with uncontrolled health conditions become less productive or are forced to leave the workforce altogether.

One important step that policymakers should take to meet this moment is to fully leverage the Health Care Affordability Fund (HCAF) by dedicating the revenue from the health insurance premium surtax that supports it entirely to improving coverage affordability, as originally intended. The HCAF was created by state legislation in 2021 to use money generated within the healthcare system to directly improve coverage affordability, particularly for low- and middle-income New Mexicans, and thereby bring down healthcare costs throughout the entire system. Since the HCAF’s creation, the state has seen record increased BeWell enrollment for four consecutive years, and saved millions for small businesses. The fund has even been expanded to assist state employees with low incomes and National Guard members. 

The HCAF has given New Mexico one of the most effective tools in the nation for improving healthcare affordability, and fully leveraging it as intended can prevent coverage losses and keep families connected to the care they need.

New Mexicans cannot afford delay, and New Mexico cannot afford to turn people away from care. Lawmakers must act immediately to protect healthcare coverage and dedicate the entire revenue coming from the health insurance surtax toward leveraging the HCAF for our families. And New Mexicans must raise their voices—call, email, and show up at the Roundhouse to demand that our healthcare lifeline is preserved. The time to act is now.