The proposed bill mandates the Health Care Authority to conduct regional commercial insurance market assessments every two years, starting July 1, 2026. These assessments will determine the average commercial insurance reimbursement rates for health care services in neighboring states, including Arizona, Colorado, Utah, Oklahoma, and Texas, that are covered by New Mexico's Medicaid program.

Additionally, the bill stipulates that the Medicaid reimbursement rate for covered health care services will be set at the greater of either 200% of the Medicare reimbursement rate or the regional average commercial insurance reimbursement rate. It also requires that at least 75% of any increase in Medicaid reimbursement revenue must be allocated by health care entities to enhance compensation for health care workers or to hire additional staff who directly interact with patients. The bill defines "health care entity" and clarifies the meanings of "Medicaid" and "Medicare" in the context of the legislation.