Legislature Should Pass All 10 Health Care Worker Compacts in 2026

By Kristina Fisher, Associate Director, Think New Mexico

The most immediate way that New Mexico lawmakers can expand access to health care is by joining all the interstate compacts for health care workers, which would make it easier for health care professionals who are licensed in other states to care for patients here in New Mexico, including via telehealth.

States that join the doctor compact experience an increase of 10-15% in the number of doctors licensed every year. 

This probably explains why states keep joining compacts and no state that has joined a compact has ever left. Forty-two states now participate in the doctor compact, 41 in the psychology compact, and 39 in the physical therapist compact. Meanwhile, New Mexico is one of only four states that participates in just one or no health care worker compacts. (We are a member of the nursing compact.)

During the 2025 legislative session, the House unanimously passed seven compacts, and Governor Lujan Grisham expressed her support. The only opposition came from a handful of powerful senators on the Senate Judiciary Committee, who blocked the compacts last session.

The good news is that, in response to increasing public pressure, the Senate Majority Leader pledged to consider the compacts for doctors and social workers during the upcoming 2026 session.

The bad news is that this leaves out the other eight compacts, even though New Mexico has shortages across all those health professions. 

For example, in order to meet national benchmarks, New Mexico needs 2,510 more EMTs, 526 more physical therapists, 281 more physician assistants, and 114 more occupational therapists, among other professions. The state’s behavioral health care system has been in crisis for over a decade, with severe shortages of psychologists and counselors. 

So what are the arguments against the compacts? We have heard three.

First, the senators who oppose the compacts object to several specific provisions, particularly the provision that prevents lawyers from suing the interstate compact commissions for their official acts. These commissions are made up of members of the medical boards of each of the participating states, and New Mexico’s medical board already has identical protection from lawsuits under our existing state law.

Notably, all of the provisions that senators object to in the compacts are included in the nursing compact, which New Mexico has participated in since 2003. The opponents of the compacts have not been able to identify any problems that have resulted from New Mexico’s participation in that compact over the past two decades. 

Second, the opposing senators have inaccurately asserted that joining the compacts could jeopardize New Mexico’s protections for health care providers who provide reproductive and gender-affirming care. 

In reality, the compacts clearly state that they do not alter any state’s authority to regulate the practice of medicine within its boundaries. The compacts also include strict limitations on information sharing between states. States like Colorado and Illinois, which have strong protections for reproductive and gender-affirming care similar to the laws in New Mexico, participate in multiple health care worker compacts without any issues.

Finally, these senators have said that there isn’t enough time to get the compacts ready for the 2026 session. However, because compacts are agreements between states, each state must agree to the same terms in order to participate. This means that if New Mexico passes a compact bill that materially changes the terms of the compact, it will not be allowed to participate.

The only changes that states can make are minor, technical tweaks to the compact wording that do not change any of the substantive terms. Legislators have had years to work with compact commission staff on crafting any wording changes they desire. The EMT compact was first introduced in 2017, and the doctor compact has been introduced repeatedly since 2019. Other compacts have also been introduced multiple times over the past five years. 

It is time for legislators to stop playing political games with New Mexicans’ access to health care and pass all 10 health care worker compacts without further delay.