Heading into the 30-day legislative session in January where state lawmakers will likely take up how medical malpractice laws contribute to New Mexico’s thinning ranks of medical professionals, it’s helpful to remember a sizable portion of New Mexico’s population — estimates vary between 540,000 and 800,000 people — lives in rural and frontier areas.
This matters. Primary care shortages are worse in less populated places than more urban and suburban towns and cities, and have been for years.
The urban-rural health care divide is a nagging reminder that there is no silver bullet to New Mexico’s shortage of medical professionals.
A new national report released Monday puts a fine point on this. Published by the Commonwealth Fund, The State of Rural Primary Care in the United States shows that 27 of New Mexico’s 33 counties are designated in part or whole as health care professional shortage areas.
The counties are composed of mostly rural and frontier areas, with small population centers like towns, villages or communities. While urban and suburban communities also suffer from big shortages of medical professionals, rural areas struggle more, the authors of the report note: “In 2023, 92 percent of rural counties were designated primary care health professional shortage areas (HPSAs), compared to 83 percent of non-rural counties.”
The struggle to staff medical professionals in New Mexico’s less populated areas is not a new story.
A 2019 assessment by New Mexico’s rural health planning working group concluded that rural communities have lower life expectancy, experiencing higher rates of disability, heart disease, cancer, diabetes, and chronic liver disease. Many rural New Mexicans also drive long distances to go to a hospital or a primary care clinic or to access basic medical services: lab work, x-rays, pharmacies.
This last data point — how far folks drive for health care — is better understood when you consider how geographically large New Mexico is. At 121,000 square miles, it is the fifth-largest state by land mass. To put this size in perspective, I often tell people you could fit into New Mexico’s borders, the state of New York and all of New England — Connecticut, Rhode Island, Massachusetts, New Hampshire, Vermont and Maine — and still have room left over for an extra Vermont. The New York-New England region is densely packed with 35 million people. New Mexico has 2.1 million.
With the rural-urban divide comes some special challenges, like rural hospitals, which are experiencing a financial crisis that could worsen with President Trump’s “Big Beautiful Bill” that passed Congress earlier this year. Rural hospitals and their advocates warned of hospital closures in the coming years due to cuts to large federal social safety net programs in the legislation. New Mexico would not be immune. The state’s federal representatives in Congress warned in June that six to eight hospitals might close in the next couple of years.
Congress added a $50 billion Rural Health Fund to the budget to mitigate the pain to rural America, but as KFF, a respected health care policy think tank, noted in an analysis: The fund would make up “a little over a third (37%) of the estimated cuts to federal Medicaid spending in rural areas.” Medicaid is the government’s health insurance program for the low-income. In addition, the fund has a five-year life span whereas “many of the major cuts related to Medicaid and the ACA Marketplaces under the law are not time limited.”
As the New Mexico Legislature noted in its Highlights document produced following the 2024 legislative session, “a 2023 statistic highlighted that more than 30% of rural hospitals nationwide are in danger of closing. New Mexico is no different; the health care provider/hospital situation in New Mexico is grim.”
I’ve known about this rural-urban health care divide since 2013 when I reported about then-Gov. Susana Martinez contemplating whether to create a health care exchange under a provision in the Affordable Care Act, better known as Obamacare. Ultimately, she did.
I wrote at the time that according to the federal government’s Health Resources and Services Administration, only one of New Mexico’s 33 counties – Los Alamos – had enough providers to adequately care for its population.
“It’s all hands on deck. We need nurses, nurse practitioners,” Dr. Arthur Kaufman, of the Office for Community Health at UNM Health Sciences Center in Albuquerque, noted at the time.
Retired physician J.R. Damron agreed.
“You can have all the insurance you want, but if you can’t get in to see your providers, then there’s going to be an access-to-care problem.”
Ten years later in 2023, my colleague, Marjorie Childress, wrote a well-researched story on the urban-rural health care divide and the challenges that thwart easy solutions to spreading health care equitably around the state.
In July of that year, the state was short 1,000 physicians and almost 7,000 nurses, according to published job announcements around the state, she found.
And in 2024, reporter Heerea Rikhraj explored a lack of maternal care in rural New Mexico. What she found were long drives for expectant moms due to closure of labor and delivery services at rural hospitals. High costs not covered by Medicaid or other sources are the culprit, hospital administrators said.
This is not to say New Mexico state lawmakers aren’t trying to address the crisis. They are.
In 2023, state lawmakers created a Rural Health Care Delivery Fund, appropriating $152 million in state and federal money to “expand primary care, maternal and child health and behavioral health services capacity in rural medically under-served areas.”
And in 2024, state lawmakers created a new fund in collaboration with hospitals to bring in additional Medicaid dollars to hospitals, and expanded the list of medical professionals that are eligible for the state’s rural health care practitioner tax credit.
It’s too soon to know what effect these changes will have. But they remind us that there is no such thing as a silver bullet when trying to fix a complex real-world problem, even one as urgent as a medical professional shortage.
Trip Jennings started his career in Georgia at his hometown newspaper, The Augusta Chronicle, before working at newspapers in California, Florida and Connecticut. Since 2005, Trip has covered politics and state government for the Albuquerque Journal, The New Mexico Independent and the Santa Fe New Mexican. He holds a Master’s of Divinity from Columbia Theological Seminary in Decatur, Ga. In 2012, he co-founded New Mexico In Depth.