NM | On March 30, 2023, a federal judge in Texas struck down major provisions of the Affordable Care Act (ACA) that require insurers to cover certain preventative services at no cost to the patient. The ruling impacts services recommended by the United States Preventive Services Task Force (USPSTF) as well as an HIV prevention medication known as pre-exposure prophylaxis (PrEP). The ruling is expected to be appealed by the Biden administration.
“This ruling undermines the health and well-being of 151 million Americans who rely on preventive services to stay healthy and detect medical issues early on while they are still manageable,” said Jennifer Catechis, New Mexico’s Interim Superintendent of Insurance. “Thankfully, our state had the foresight to ensure these protections are enshrined in state law.”
In 2019, New Mexico passed a law adopting many of the ACA’s consumer protections for major medical
plans that are regulated by the state. The law requires insurers to cover all preventive services, including those recommended by the USPSTF.
“I was proud to sponsor HB 436 in 2019 to ensure that the ACA’s protections were codified in state law,” said state Representative Liz Thomson, who sponsored the legislation to add the protections into law. “Lawsuits like this are exactly why we passed HB 436. One judge in Texas should not be able to interfere with the health of patients in New Mexico.”
New Mexico’s preventive service protections apply to all major medical individual and group plans regulated by the Office of Superintendent of Insurance (OSI), including large employer plans. The state does not have the authority to regulate certain plans offered by businesses who “self-fund” their own employer-sponsored health plans, meaning New Mexico’s protections do not extend to these types of coverage.