Bill > SB189

This bill mandates that various health insurance plans, including group health coverage, self-insurance, health maintenance organization (HMO) contracts, and nonprofit health care plans, must cover specific reproductive, sexual, and gender-affirming health care services without requiring the insured to pay deductibles, copayments, or coinsurance, which are collectively known as "cost-sharing." Specifically, it requires coverage for preventive services recommended by the U.S. Preventive Services Task Force, immunizations, and comprehensive preventive care for infants, children, adolescents, and women as outlined by the Health Resources and Services Administration (HRSA). The bill also ensures coverage for the total cost of abortion care and gender-affirming care, defined as medical services prescribed to treat incongruence between an individual's gender identity and sex assigned at birth. Furthermore, it establishes a special enrollment period for individuals who become pregnant, allowing them to obtain coverage even if they were previously uninsured, with coverage becoming effective quickly. The bill also expands coverage for contraception, requiring plans to cover all FDA-approved methods, clinical services related to contraception, and allows for a twelve-month supply to be dispensed at once, removing prior authorization and quantity limits for most plans, with exceptions for high-deductible health plans until the deductible is met, and for certain limited-benefit plans. It also updates provisions for medical assistance programs to ensure reimbursement for family planning services and supplies without unnecessary controls and mandates coverage for lactation support services and supplies. These provisions are set to apply to policies, plans, contracts, and certificates delivered, issued for delivery, renewed, extended, or amended in the state starting January 1, 2027.

https://www.nmlegis.gov/Legislation/Legislation?chamber=S&legtype=B&legno=189&year=26