RIO RANCHO — Hospital executives and clinicians from New Mexico’s largest nonprofit health network told U.S. Sen. Ben Ray Luján on Thursday that proposed federal Medicaid changes, temporary telehealth waivers and caps on graduate medical education funding are creating serious financial and access risks for the state’s health-care system.
System leaders warn of immediate financial exposure
At a roundtable hosted at Presbyterian Rust Medical Center, Presbyterian Delivery System President Chad Aduddell described modeling that shows “significant financial exposure” stemming from a federal budget package that includes new Medicaid work requirements set to take effect in January. Aduddell said New Mexico is, on a per-capita basis, more exposed to that requirement than other states.
"[Presbyterian] will 'stop receiving compensation' for care it continues providing to patients who lose coverage," Aduddell told Luján, according to meeting notes.
Presbyterian has grown from a 1908 tuberculosis sanatorium into the state’s largest integrated health system, and hospital leaders emphasized the breadth of their operations as the stakes of federal change.
| Presbyterian Delivery System | Metric |
|---|---|
| Hospitals | 9 |
| Employed clinicians | More than 1,200 |
| Population reach | Serves roughly one in two New Mexicans |
Rural access, telehealth and workforce concerns
Physicians at the meeting urged Luján to press Congress to act on telehealth policy. Many rural patients in New Mexico depend on pandemic-era waivers that eased restrictions on cross-state and cross-site telemedicine. Those waivers remain temporary and require renewal, creating uncertainty for communities with limited in-person access.
Luján said he is working on legislation to secure permanent telehealth reimbursement but conceded that Congress has not yet enacted permanent waivers, leaving rural patients and providers in limbo.
Leaders also raised concerns about federal caps on graduate medical education (GME) funding. Dr. David Arredondo, Presbyterian’s chief medical officer, warned that limits on federally funded residency slots will curtail how many new physicians hospitals can train — even as the University of New Mexico prepares to double its medical school class size.
Because physicians commonly practice where they complete residency training, Arredondo said New Mexico risks producing medical school graduates who leave the state to complete residencies elsewhere — a dynamic that could worsen chronic clinician shortages in rural communities.
What hospital leaders want from Washington
Participants identified several federal policy fixes they say would help stabilize care in New Mexico:
- Preserve Medicaid coverage and avoid policies that would sharply reduce enrollment, such as strict work requirements tied to eligibility.
- Make pandemic-era telehealth flexibilities permanent or enact reimbursement rules that ensure rural providers can be paid for remote care.
- Adjust or expand federal GME funding caps to allow hospitals to add more residency slots to match increased medical school output.
Those concerns reflect both short-term budgetary pressures and long-term workforce planning challenges. Hospital officials warned that losing Medicaid reimbursements would not only threaten safety-net care for low-income New Mexicans but also raise costs across the system, as uncompensated care drives up operating losses that must be offset.
Lawmakers balance competing pressures
Luján, who represents New Mexico in the Democrat-controlled delegation, reiterated his focus on those issues but acknowledged the difficulty of securing swift congressional action. He described telehealth reimbursement legislation as a work in progress and emphasized his role in trying to shield New Mexico from policy shifts that would deepen rural health disparities.
Presbyterian leaders framed their message as a warning that federal decisions made far from New Mexico’s clinics will have material effects on hospitals, patients and insurance markets here.
Health-care providers across the state continue to monitor federal rulemaking and legislative developments closely. For New Mexicans who rely on Medicaid and on remote care, the coming months will determine whether current coverage and access arrangements remain in place or are altered by budget and regulatory changes in Washington.
Reporting for this story included comments provided during the Aug. 13 roundtable at Presbyterian Rust Medical Center.
