In a report issued Sept. 23, 2025, legislative analysts found New Mexico’s costs for its Medicaid program have nearly doubled in nine years, even as enrollment has dropped. (Getty Images)
As New Mexico lawmakers prepare to convene next week in part to address the federal spending bill’s impact on Medicaid, legislative analysts say the state’s costs for the program have nearly doubled in nine years, even as enrollment has dropped. In addition, clients report ongoing issues with doctor availability.
Legislative Finance Committee analysts presented their report to lawmakers during an interim committee meeting on Tuesday in Hobbs. Overall, the report says, the state’s Health Care Authority since 2016 has nearly doubled total spending on Medicaid — to $11 billion — despite serving 31,000 fewer New Mexicans.
The report also includes the results of a secret shopper survey from August, which backs up anecdotal concerns regarding long wait lists and difficulty securing appointments. Analysts called 256 primary care physicians and 259 doctors to seek behavioral health care appointments under Medicaid, and found it took an average of six phone calls to secure an appointment. Nearly one in five doctors listed on directories from insurance companies could no longer be found or were “inappropriate for the specialty.” Another 17% of providers either did not return calls or could not be reached.
Financial analyst Allegra Hernandez noted that Medicaid represents the state’s most vulnerable populations: low-income people, pregnant women, children and people with behavioral health issues.
“The systems are not improving for users in the way that we would expect and hope with these investments,” Hernandez said. “Moreover, spending has increased significantly, and these payoffs are not yet demonstrated to have shown up.”
Finally, analysts said the state still is not tracking, in real time, what services patients are using.
In a rebuttal, Health Care Authority Chief Medical Officer Alanna Dancis told lawmakers that some of the measures in the report are “a little bit misleading,” saying that the analysis in the report does not align with any other accountability measures requested by the federal government or lawmakers.
“We just would like to work together to kind of pick how we’re evaluated from the front end so that we have our best chance of being successful,” Dancis said.
Dancis said the agency has added nearly 2,000 new providers, including 469 new behavioral health workers and 189 new licensed therapists, based on new state laws passed by lawmakers, and that rising costs of the program in recent years were anticipated.
“We’re right where we expect to be after so much growth,” Dancis said.
As such, Dancis disputed the survey conclusions that the program has inadequate providers. While “we can all agree that six calls is too many calls to make to try to schedule an appointment,” she said, better provider directories might address the issue.
New Mexico has the highest per-capita enrollment in Medicaid, the federal-state health insurance program for low-income people, amounting to about 38% of the state, according to the state’s latest data. The New Mexico Health Care Authority estimates that more than 80,000 New Mexicans could lose coverage due to the new work requirements and reregistering every six months beginning in December of 2026.
While the Health Care Authority is expected to ask lawmakers for additional administrative funding in anticipation of federal cuts, Charles Sallee, director of the Legislative Finance Committee, urged caution later in the day during a presentation on the federal impacts.
The HCA will ask for more funding to administer new work requirements and evaluate eligibility for assistance programs every six months, Sallee said. But he noted, per an LFC analysis, that state employees’ caseloads for food stamps, Medicaid and Temporary Assistance to Needy Families are down 21% since before the COVID-19 pandemic.
Lawmakers should be prudent during the special session, he said, in light of how much non-recurring spending lawmakers have already allocated for the upcoming 30-day session and with fears about a looming federal government shutdown.
“I worry about spending that down before you get into the regular session, to be perfectly honest with you, because I think we’re facing headwinds economically,” he said. “And I worry about what that what the next couple of months are going to entail, just from our broader-based economic prosperity.”
Sen. Linda Trujillo (D-Albuquerque) spoke of her own challenges in securing appointments with doctors and specialists in the state and asked if the state has any data for how doctors may be leaving practices or the state altogether.
Harry Rommel, a fiscal analyst, said the LFC is working to track physician migration, but said the New Mexico Department of Health still hasn’t granted the committee access to a database tracking payments to doctors, but when that happens the state can find out if physicians are moving to private practices, or leaving the New Mexico altogether.
“That’s a missing link to figure out what’s really happening out there,” Trujillo said.
Patrick Lohmann contributed to the writing and reporting of this story.
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