Summary:

 Senate Bill 508 (SB 508):  This comprehensive legislation broadens insurance coverage for reproductive and gender-affirming health care in New Mexico’s public and private insurance markets. It ensures no cost sharing for abortion services, eliminates utilization controls for family planning, expands contraceptive benefits, and requires coverage of gender-affirming care. The effective date is January 1, 2026, giving insurers and government programs time to implement these expanded benefits. 

Legislation Overview:

 Senate Bill 508 (SB 508):  The proposed legislation, which expands and clarifies coverage for reproductive health, gender-affirming care, contraceptive access, and abortion services under various health plans—while eliminating or limiting cost-sharing and prior authorization for certain services.
•	Scope of the Legislation - The bill modifies and enacts new sections within:
•	The Health Care Purchasing Act (covering state employee/group plans and other public plans)
•	The Public Assistance Act (applying to Medicaid and other state-funded programs)
•	The New Mexico Insurance Code (covering private health insurance, including HMOs and nonprofit health care plans)
•	The changes apply to health plans issued, amended, or renewed on or after January 1, 2026.
No-Cost Preventive Services:
•	Prevention & Screening
•	Mandates no cost-sharing (zero copay/coinsurance) for services rated A or B by the U.S. Preventive Services Task Force, plus immunizations recommended by the CDC and certain additional guidelines for infants, children, and women.
•	Special Enrollment for Pregnancy
•	Requires special enrollment for pregnant individuals outside standard open enrollment, ensuring coverage starts before the end of the first month in which pregnancy is certified.
Abortion Services:
•	No Cost Sharing
•	Prohibits cost-sharing (copays/deductibles/coinsurance) for abortion care.
Exception: High deductible health plans may apply deductible only until it is met. – Coverage:
•	All relevant plans must cover the total cost of abortion care as a distinct, non-bundled set of services.
•	Medicaid must reimburse abortion providers separately, allowing for modifier codes to reflect specialized care.
Gender-Affirming Care - Mandatory Coverage:
•	Requires coverage of gender-affirming care, broadly defined as procedures, services, drugs, devices, or products prescribed to treat incongruence between a person’s gender identity and assigned sex at birth.
No Cost Sharing:
•	Generally no cost-sharing unless it’s a high deductible health plan and the deductible hasn’t been met (unless federal law allows otherwise).
Family Planning & Contraceptive Coverage - Expanded Contraception:
•	Plans must cover all FDA-approved contraceptive methods without cost sharing, prior authorization, or step therapy. This includes over-the-counter products (OTC)—no prescription needed.
Brand-Name Exception: Plans may impose cost-sharing on brand-name versions if a therapeutically equivalent generic is offered for free—but must cover brand-name if deemed medically necessary.
•	12-Month Supply
•	Must cover 12-month supply of self-administered contraceptives at once if prescribed and requested.
•	Prohibits quantity limits that would result in less than 12 months being dispensed over the year.
•	Family Planning Services
•	No prior authorization or utilization controls for Medicaid’s family-planning and related services, including abortion care, miscarriage management, STI treatment, and fertility services.
•	Lactation Support
•	Mandates coverage of lactation supplies/equipment (e.g., breast pumps) before delivery and postpartum.
•	Focuses on multi-user pumps for families with special medical needs (e.g., premature infants).
No Prior Authorization or Cost-Sharing for Certain Services
•	Sexual, Reproductive, & Gender-Affirming Services
•	Eliminates or severely restricts prior authorization and step therapy for abortion, contraception, gender-affirming care, etc.
•	High Deductible Plans
•	Some provisions (e.g., zero cost sharing) don’t apply until the deductible is met, to comply with IRS rules for HSA-eligible high deductible plans.
•	After the deductible, cost-sharing must be waived in these same categories.
Implementation & Exemptions
Effective Date - January 1, 2026.
•	Plan Types Not Included
•	Short-term, limited-benefit, travel, accident-only, hospital-indemnity-only, or specified-disease policies are exempt from many of these requirements.
•	Religious Exemption
•	Religious entities may continue to exclude prescription contraceptive coverage from purchased plans.
 

Current Law:

 Sections 1 – 4 is proposed “New Material”; 
SECTION 5.  Section 13-7-22 NMSA 1978 (being Laws 2019,
 Chapter 263, Section 1) is amended to read:
 "13-7-22.  COVERAGE FOR CONTRACEPTION.
13-7-22. Coverage for contraception. 
A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that provides coverage for prescription drugs shall provide, at a minimum coverage. 
SECTION 6.  Section 27-2-12.29 NMSA 1978 (being Laws 2019,
 Chapter 263, Section 2) is amended to read:
 "27-2-12.29.  MEDICAL ASSISTANCE--REIMBURSEMENT FOR A ONE
YEAR SUPPLY OF COVERED PRESCRIPTION CONTRACEPTIVE DRUGS OR
 DEVICES.
27-2-12.29. Medical assistance; reimbursement for a one-year 
supply of covered prescription contraceptive drugs or devices. 
A. In providing coverage for family planning services and supplies under the 
medical assistance program, the department shall ensure that a recipient is permitted to fill or refill a prescription for a one-year supply of a covered, self-administered contraceptive at one time, as prescribed. B. Nothing in this section shall be construed to limit a recipient's freedom to choose 
or change the method of family planning to be used, regardless of whether the recipient has exhausted a previously dispensed supply of contraceptives.
Sections 7– 10 is proposed “New Material”
Section 11.  Section 59A-22-42 NMSA 1978 (being Laws
 2001, Chapter 14, Section 1, as amended) is amended to read:
 "59A-22-42.  COVERAGE FOR PRESCRIPTION CONTRACEPTIVE
 DRUGS OR DEVICES. 
59A-22-42. Coverage for prescription contraceptive drugs or 
devices. 
A. Each individual and group health insurance policy, health care plan and 
certificate of health insurance delivered or issued for delivery in this state that provides a prescription drug benefit shall provide, at a minimum, the following coverage: 
(1) at least one product or form of contraception in each of the contraceptive 
method categories identified by the federal food and drug administration; 
(2) a sufficient number and assortment of oral contraceptive pills to reflect the 
variety of oral contraceptives approved by the federal food and drug administration; and 
(3) clinical services related to the provision or use of contraception, including 
consultations, examinations, procedures, ultrasound, anesthesia, patient education, counseling, device insertion and removal, follow-up care and side-effects management. 
Sections 12– 14 is proposed “New Material”
Section 15. Section 59A-23-7.14 NMSA 1978 (being Laws
 2019, Chapter 263, Section 5) is amended to read:
59A-23-7.14. Coverage for contraception. 
A. Each individual and group health insurance policy, health care plan and 
certificate of health insurance delivered or issued for delivery in this state that provides a prescription drug benefit shall provide, at a minimum, the following coverage: 
(1) at least one product or form of contraception in each of the contraceptive 
method categories identified by the federal food and drug administration; 
(2) a sufficient number and assortment of oral contraceptive pills to reflect the 
variety of oral contraceptives approved by the federal food and drug administration; and 
(3) clinical services related to the provision or use of contraception, including 
consultations, examinations, procedures, ultrasound, anesthesia, patient education, counseling, device insertion and removal, follow-up care and side-effects management. 
Sections 16– 18 is proposed “New Material”
SECTION 19.  Section 59A-46-44 NMSA 1978 (being Laws
 2001, Chapter 14, Section 3, as amended) is amended to read:
59A-46-44. Coverage for contraception. 
A. Each individual and group health maintenance organization contract delivered or issued for delivery in this state that provides a prescription drug benefit shall provide, at a minimum, the following coverage: 
(1) at least one product or form of contraception in each of the contraceptive 
method categories identified by the federal food and drug administration. 
(2) a sufficient number and assortment of oral contraceptive pills to reflect the 
variety of oral contraceptives approved by the federal food and drug administration; and 
(3) clinical services related to the provision or use of contraception, including 
consultations, examinations, procedures, ultrasound, anesthesia, patient education, counseling, device insertion and removal, follow-up care and side-effects management.
Section 20 – 22 is proposed “New Material”
SECTION 23.  Section 59A-47-45.5 NMSA 1978 (being Laws
 2019, Chapter 263, Section 9) is amended to read:
 59A-47-45.5. Coverage for contraception. 
A. A health care plan delivered or issued for delivery in this state that provides a prescription drug benefit shall provide, at a minimum, the following coverage: 
(1) at least one product or form of contraception in each of the contraceptive 
method categories identified by the federal food and drug administration; 
(2) a sufficient number and assortment of oral contraceptive pills to reflect the 
variety of oral contraceptives approved by the federal food and drug administration; and 
(3) clinical services related to the provision or use of contraception, including 
consultations, examinations, procedures, ultrasound, anesthesia, patient education, counseling, device insertion and removal, follow-up care and side-effects management. 
Sections 24– 25 is proposed “New Material”