No Behavioral Health Cost Sharing
SB 120 amends multiple New Mexico insurance and health coverage statutes to prohibit cost sharing for in-network behavioral health services. The bill applies this rule across the Health Care Purchasing Act, individual and group health insurance policies, group and blanket policies, health maintenance organization contracts, and health care plans. It defines behavioral health services broadly to include treatment, prevention, identification, and habilitation services for mental illness, substance use disorders, and trauma spectrum disorders, as well as inpatient, detoxification, residential treatment, partial hospitalization, intensive outpatient therapy, outpatient therapy, and medications, including brand-name drugs when generics are unavailable.
The bill also defines key cost-sharing terms such as copayments, coinsurance, and deductibles, and it specifies that the prohibition applies only to in-network services. It creates explicit exemptions for excepted benefit plans, catastrophic plans, and high-deductible health plans with health savings accounts until the deductible is met, unless federal law allows otherwise. The effective date is January 1, 2026.
SB 120 would expand and standardize New Mexico’s existing behavioral health parity-style protections by removing out-of-pocket cost sharing for covered in-network behavioral health services across several categories of regulated health coverage. It would amend sections of the Health Care Purchasing Act and the New Mexico Insurance Code, affecting insurers, HMOs, health care plans, self-insured group coverage under the Act, and enrollees/subscribers who receive behavioral health care. The practical effect is to shift more of the cost of mental health and substance use treatment from patients to health plans, while preserving certain federal-law-based exceptions.
The voting history suggests the bill had meaningful but not unanimous support. It passed the Senate 19-14 and the House 45-17, indicating a majority in both chambers but with a notable minority opposed. The caption and structure of the bill suggest it was framed as a behavioral health access measure, and the broad final-passage majorities indicate generally favorable sentiment toward eliminating cost sharing for these services.
The main points of contention likely center on the cost and scope of the mandate. Opponents may object that eliminating copays, coinsurance, and deductibles for behavioral health services could increase premiums or impose additional costs on insurers and employers, especially because the bill applies broadly across multiple plan types. Another likely issue is the bill’s limited exemptions: it excludes only certain plan categories such as excepted benefit plans, catastrophic plans, and high-deductible health plans until the deductible is met, which may have raised concerns about administrative complexity and the interaction with federal health law. Supporters, by contrast, would be expected to emphasize improved access to mental health and substance use treatment and reduced financial barriers to care.