This bill amends the Health Care Purchasing Act, the Public Assistance Act, and the New Mexico Insurance Code to enhance coverage for sexual, reproductive, and gender-affirming health care services. Key provisions include the requirement for group health coverage to provide no-cost sharing for preventive benefits, abortion care, and gender-affirming care. It establishes a special enrollment period for pregnant individuals and mandates that contraceptive coverage includes a sufficient quantity for continuous use without cost sharing or prior authorization. Additionally, the bill ensures that family planning services are reimbursed without limitations and emphasizes lactation support, while expanding contraceptive coverage to include over-the-counter options.

The legislation also clarifies that insurers cannot impose restrictions on coverage, including quantity limits for contraception, and mandates expedited appeals processes for adverse determinations. It specifies that health maintenance organization contracts must cover gender-affirming care and abortion services without cost sharing. Furthermore, the bill allows religious entities to exclude prescription contraceptive drugs from their coverage and outlines that these provisions will not apply to high deductible health plans until the deductible is met. The effective date for these changes is set for January 1, 2026.

Statutes affected:
introduced version: 13-7-22, 27-2-12.29, 59A-22-42, 59A-23-7.14, 59A-46-44, 59A-47-45.5