By Julia Burleson and Stacey Pogue
Elevated hospital consolidation and personal fairness in well being care have raised widespread considerations about increased prices, lowered entry, decrease high quality, and decreased competitors. In New Mexico, a proposed merger between a neighborhood hospital system and a bigger out-of-state system aimed to create a 48-hospital system with roughly $11 billion in annual income. Though the transaction fell by way of, it highlighted the state’s lack of oversight mechanisms for mergers and acquisitions and spurred legislative motion.
In 2024, New Mexico enacted the Well being Care Consolidation Oversight Act (SB 15) and strengthened the legislation in 2025 with HB 586, which prolonged and expanded its authority. Whereas the 2025 laws constructed on the muse laid in 2024, it in the end fell brief of its preliminary ambitions after encountering robust opposition from the hospital trade and allied enterprise and supplier teams. Nonetheless, the state’s current efforts lay the groundwork for a strong and clear oversight framework, which can develop into more and more vital as monetary pressures from the federal One Large Stunning Invoice Act (H.R. 1) drive a potential new wave of mergers and acquisitions.
The Threat of Hospital Consolidation and Personal Fairness in New Mexico
New Mexico’s hospital sector is very consolidated, with KFF ranking all 4 of its metro areas as extremely concentrated. As well as, non-public fairness companies personal 36% of New Mexico’s hospitals—the best proportion of any state. On the time state legislators launched SB 15 in 2024, New Mexico had no formal oversight course of for hospital transactions, in contrast to most states.
In response, Consultant Reena Szczepanski and Senator Katy Duhigg sponsored profitable laws in each 2024 and 2025 to authorize state overview and approval of mergers and acquisitions involving hospitals. The legislators emphasised that the payments don’t block funding, however intention to make sure the state evaluates main well being care transactions for his or her potential influence on entry, value, and high quality.
They argued that non-public fairness companies, which have a fiduciary responsibility to prioritize shareholder income, could make choices that don’t align with neighborhood well being wants. The sponsors cited analysis linking non-public fairness possession to decreased high quality of care, together with testimony from suppliers, sufferers, and advocates throughout the state in regards to the impacts of hospital consolidation. By listening periods with stakeholders, Senator Duhigg and Superintendent of Insurance coverage Alice Kane heard reviews of lowered entry to important companies comparable to labor and supply companies, following consolidations. The invoice sponsors additionally pointed to hospital consolidation as an element contributing to rising well being care prices. In 2020, common spending on hospital care was $3,960 per particular person, increased than in neighboring states.
Momentary Hospital Consolidation Oversight Authority Enacted in 2024
New Mexico enacted the Well being Care Consolidation Oversight Act (SB 15) in 2024, which briefly approved the Workplace of Superintendent of Insurance coverage (OSI), in session with the state’s Well being Care Authority, to overview and approve or deny mergers, acquisitions, and different transactions that may end in a change accountable for a hospital. OSI’s overview considers the influence the proposed transaction may have on entry to companies, high quality of care, affected person affordability, and competitors out there. As well as, the legislation granted OSI authority to conduct post-transaction oversight for 3 years to watch compliance with any situations positioned on accredited transactions and different outcomes.
The sundown date within the legislation repealed authority a yr later (as of July 1, 2025), giving invoice sponsors time to assemble stakeholder enter and craft a extra complete and everlasting strategy for the 2025 legislative session.
Ups and Downs within the 2025 Session Yield Everlasting and Expanded Authority
Following the passage of SB 15, OSI and invoice sponsors performed listening periods across the state, and heard from client advocates, neighborhood members, insurers, well being care suppliers, and hospital leaders. Within the fall of 2024, invoice sponsors outlined the extra complete strategy they deliberate to absorb the 2025 session, together with a timeline for taking stakeholder enter on the draft legislative language previous to session.
Invoice sponsors filed SB 14 in 2025, which sought to extend the transparency of proposed transactions and increase oversight to further kinds of transactions and entities past hospitals, together with different well being care suppliers and personal fairness buyers. SB 14 confronted overwhelming trade pushback and was voted down in committee. Proponents scrambled to seek out one other path to prolonged expiring state oversight authority in New Mexico’s brief, 60-day session, in the end amending and passing a substitute invoice, HB 586. To move the invoice, sponsors scaled again a number of provisions, for instance, ensuring data on proposed transactions confidential in response to considerations from the state’s hospital affiliation.
Whereas HB 586 is pared down in comparison with SB 14, it expands on 2024’s SB 15 in a number of methods, together with:
- Making the state’s oversight authority everlasting;
- Increasing oversight to further transactions, together with acquisitions of unbiased well being care practices by a well being insurer or its affiliated corporations and modifications accountable for the true property a hospital sits on;
- Making among the data within the discover of proposed transaction public, together with the targets of the transactions and areas, companies, and teams impacted, and permitting public touch upon transactions underneath overview;
- Permitting the state’s overview to contemplate the transaction’s influence on worker salaries and dealing situations;
- Shifting oversight authority from OSI to the Well being Care Authority; and
- Establishing monetary penalties and non-compliance and whistleblower protections for hospital staff or others who report improper acts.
Wanting forward
Whereas proponents in each 2024 and 2025 aimed to ascertain extra strong well being care consolidation oversight modeled on Oregon’s authority, opposition from hospitals and trade teams compelled compromises. But, New Mexico’s iterative course of reveals how sustained legislative engagement, stakeholder outreach, and a willingness to adapt can result in significant coverage growth, even within the face of highly effective opposition. By constructing a basis for transparency, public accountability, and state-level approval authority, New Mexico is now higher positioned to answer the affect of hospital consolidation and personal fairness in well being care.
New Mexico joins a rising quantity of states with hospital consolidation oversight authority that extends past discover and overview to leverage approval authority and post-transaction monitoring. These oversight instruments could develop into more and more vital to states if shifts in federal coverage speed up hospital consolidation, impacting native entry to and affordability of well being care.