Committee approves expansion so counties may use health‑care assistance funds to buy insurance premiums and out‑of‑pocket costs

The Senate Health and Public Affairs Committee on Friday approved Senate Bill 45, which would explicitly allow counties to use their county health care assistance funds to pay insurance premiums and related costs for indigent county residents, and sent the bill to the Senate with a do‑pass recommendation.

Sponsor Senator (Steinborn in transcript) said the change permits counties to use an existing local revenue source to cover premiums and direct health care costs — an option intended as a last resort for people who do not qualify for Medicaid or who fall just above eligibility thresholds. “Counties already have them,” the sponsor said. “In my county, they collect about $9 million a year. It would just vastly enable them to cover more people.”

The bill’s amendment, adopted in committee, clarifies that county purchases may include public program premiums — for example, premium buy‑ins — not just private insurance. Supporters included county health directors and the New Mexico Center on Law and Poverty, which said the bill gives counties flexibility to use a dedicated local fund to expand coverage and reduce uncompensated care costs for hospitals.

Opponents were not present in force; the municipal league and county officials have previously discussed implementation details. The record included a statement from the Dona Ana County Health and Human Services director (Jamie Michael) explaining the county’s current use of its fund and that the program is intended as a payer of last resort for residents domiciled in the county.

Committee members asked about eligibility, outreach and administration: witnesses said counties would administer the program and that state law limits benefits to county domiciled residents. Sponsors said the proposal is permissive — counties would adopt the expanded use through local decisions and could choose whether to supplement the fund with other county dollars.

Committee action: the committee approved the amendment clarifying coverage of public program premiums and voted to recommend the bill for passage; the vote count was recorded as 6–2 in favor. Sponsors and county staff said the change could help thousands of people in larger counties; the sponsor estimated up to 3,500 people in Dona Ana County could benefit if the county used the fund for premiums and out‑of‑pocket costs.

The bill moves to the next stage with a committee recommendation; senators said implementation details — eligibility rules, outreach to eligible residents and coordination with federal subsidies — are matters for counties and the health care authority to refine.