New Mexico to Launch Medicaid Pilot Program in Prisons by 2026

New Mexico’s Health Care Authority is set to implement a pilot program that will enroll eligible incarcerated individuals in Medicaid, expected to launch by April 2026, pending federal approval. This initiative aims to provide Medicaid-funded healthcare to eligible New Mexicans up to 90 days before their release, addressing a crucial gap in healthcare access for those re-entering society. The program will initially be piloted in three prisons across the state.

The Health Care Authority announced the program, dubbed “JUST Health Plus,” as a means to assist individuals transitioning from incarceration, emphasizing the importance of healthcare in reducing recidivism rates. Tim Fowler, a spokesperson for the authority, noted that although the program was launched in July 2024, enrollment has yet to begin due to pending federal reimbursement approvals. He stated, “Once the [Health Care Authority] receives federal approval, we can begin providing Medicaid services to eligible individuals in participating prisons and jails.”

New Mexico is one of 19 states authorized to pilot a pre-release Medicaid coverage program, according to the health policy organization KFF. Federal law typically bars the use of Medicaid funds for incarcerated individuals, making state-level pursuit of a Section 1115 waiver essential to facilitate this program.

Challenges remain regarding the availability of healthcare providers willing to serve the prison population. Haven Scogin, deputy director of reentry for the New Mexico Corrections Department, highlighted the difficulties in finding providers in rural areas, stating, “If I have someone exiting [prison] to Albuquerque, I don’t have any issue at all finding them a provider.” However, she acknowledged that access becomes complicated in regions with fewer medical resources.

Despite these challenges, Fowler reported a growing interest among healthcare providers to support the program. He mentioned, “We’re seeing a growing interest from providers who want to support this work and help people get the care they need as they return to their communities.”

During a recent Legislative Finance Committee hearing, state representatives expressed optimism about the potential impact of the program. Rep. Tara Lujan, D-Santa Fe, remarked on the significance of reentry initiatives in Santa Fe County, stating, “I think that this is really incredibly important work that we’re doing.”

The Health Care Authority’s pilot program will be operational in three facilities: the Central New Mexico Correctional Facility in Los Lunas, the Western New Mexico Correctional Facility in Grants, and the Springer Correctional Center in Springer. According to Brittany Roembach, public information officer for the Corrections Department, there are currently 526 individuals eligible for enrollment in the program.

As the program develops, the Corrections Department plans to provide certain reentry services and will rely on Medicaid reimbursement instead of state funds. Wenceslaus Asonganyi, health services administrator for the Corrections Department, noted that the state is already delivering essential services but aims to enhance its capabilities through Medicaid.

State Rep. Harlan Vincent, R-Glencoe, raised concerns regarding the program’s effectiveness, pressing the department for data demonstrating reduced recidivism and effective spending. “We’re throwing money at something, and I want to know that we’re getting a return on our investment,” he stated. Asonganyi confirmed that the state would collect necessary data as mandated by federal requirements but acknowledged the complexities of linking healthcare access directly to recidivism rates.

The prerelease services outlined by the Health Care Authority include case management, medication-assisted treatment, and a 30-day supply of medication upon release. Looking ahead, the Health Care Authority plans to expand the program to additional prisons and four county jails in the coming years, including facilities in Santa Fe, Valencia, Socorro, and Bernalillo counties, as well as the Bernalillo Juvenile Detention Center.

Fowler emphasized that the department will continuously assess the readiness of facilities to accommodate the remaining prisons and jails, ensuring that the program can effectively support those transitioning back into their communities.