New Mexico to Launch Medicaid Pilot in Prisons by April 2026

New Mexico’s Health Care Authority is preparing to launch a pilot program that aims to enroll incarcerated individuals in Medicaid by April 2026, contingent upon final federal approval. The initiative will allow eligible incarcerated New Mexicans to receive Medicaid-funded healthcare for up to 90 days before their release, addressing significant barriers to accessing medical services during the reentry period.

The pilot, named “JUST Health Plus,” commenced in July 2024 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. As of now, no inmates have been enrolled as the state awaits federal reimbursement approval, according to Tim Fowler, a spokesperson for the Health Care Authority.

Once approved, Fowler anticipates that Medicaid services will begin for eligible individuals in participating prisons and jails. He noted that the program is one of only 19 statewide initiatives that have received federal authorization to operate a pre-release Medicaid coverage program. Federal law typically restricts Medicaid funding for incarcerated individuals, necessitating a federal waiver under Section 1115 for states to proceed.

At a recent Legislative Finance Committee hearing, lawmakers and prison officials expressed concerns about the availability of medical providers willing to offer care to the prison population, particularly for conditions like opioid use disorder. Haven Scogin, deputy director of reentry for the New Mexico Corrections Department, highlighted the difficulties of securing health providers, especially in rural areas.

“If I have someone exiting [prison] to Albuquerque, I don’t have any issue at all finding them a provider,” Scogin stated, emphasizing that challenges arise when individuals are released to less populated regions where provider access is limited. Despite these hurdles, Fowler mentioned that there is a growing interest from healthcare providers to support returning citizens.

State Representative Tara Lujan remarked on the importance of reentry programs, noting potential advancements happening in Santa Fe County.

The federal Centers for Medicare and Medicaid Services approved New Mexico’s program in July. Setting up the pilot required significant changes, including updating provider enrollment systems and developing a reimbursement process. Currently, there are approximately 526 individuals eligible to enroll in Medicaid through the pilot program at the three designated facilities.

As part of the initiative, the Corrections Department will continue to provide certain reentry services but will receive Medicaid reimbursement rather than relying solely on state funds. Ultimately, every Medicaid-eligible individual in state or county prisons, jails, or juvenile correctional facilities will be eligible for services up to 90 days prior to their release.

Concerns about accountability also surfaced during the committee meeting. Harlan Vincent, a Republican representative from Glencoe, pressed the Corrections Department for assurances that the program would effectively reduce recidivism and provide a solid return on investment. “I can’t imagine making a better investment in people, but if it’s not working, we’ve got to have a plan,” he stated.

Asonganyi, the health services administrator for the Corrections Department, indicated that while the state will collect data as mandated by the federal government, demonstrating a direct link between the program and reduced recidivism remains a complex challenge. He called for further investment in the justice system’s data infrastructure to improve outcomes.

The prerelease services outlined under the program will include case management, medication-assisted treatment, and a 30-day supply of medication upon release. By 2026, the Health Care Authority plans to expand the initiative to additional prisons and four county jails, including facilities in Santa Fe, Valencia, Socorro, and Bernalillo counties, along with the Bernalillo Juvenile Detention Center. Fowler affirmed that facility readiness assessments will continue as further expansion is considered.