New Mexico - So Every BODY Can Move

ENACTED

New Mexico HB-131

Bill Number:

HB 131

Status:

Enacted

Date Signed Into Law:

4/6/2023

Date Law Goes Into Effect:

1/1/2024

Plans Affected:

State Commercial Plans + State Employee Plans + Medicaid

Age Group:

All Ages

Types of Devices Covered:

Orthoses + Prostheses

State Lead:

Kyle Stepp, Laura Lewis

Primary Bill Sponsors:

Rep. Elizabeth “Liz” Thomson (Lead House Sponsor), Rep. Kathleen Cates, Rep. Joshua Hernandez, Rep. John Block, Rep. Gail Armstrong, Sen. Siah Correa Hemphill (Lead Senate Sponsor)

Contact Your Representative

At a Glance

New Mexico Statistics

Physical activity is one of the most important factors in maintaining overall health throughout one’s lifetime. Whether it’s vigorous exercise or simple day-to-day movement, being physically active increases strength and balance, improves mental health, supports better-quality sleep, and reduces the risk of disease and cancer for every body, including people with disabilities.

4.5X

Children with disabilities are 4.5 times less likely to engage in physical activity compared to their peers.

American College of Sports Medicine, Why We Must Prioritize Equitable Access to Physical Activity for Children with Disabilities

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1 in 2

50% of adults with disabilities get absolutely no aerobic physical activity.

Centers for Disease Control and Prevention (CDC), Inactivity Related to Chronic Disease in Adults with Disabilities

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Adults and children with mobility limitations are at greatest risk for obesity and the prevalence of obesity in children with disabilities is almost twice that of children without disabilities.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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60 / 150 Mins

The U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans recommends children with disabilities get 60 or more minutes each day of moderate or vigorous intensity aerobic physical activity; for adults with disabilities, the recommendation is 150 minutes weekly.

U.S. Department of Health and Human Services, Physical Activity Guidelines for Americans, 2nd Edition

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$44 Billion

Annual health care costs of obesity that are related to disability are estimated at approximately $44 billion.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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“F”

According to the 2022 U.S. Report Card on Physical Activity for Children and Youth, the U.S. received an “F” grade for children with disabilities, with less than 17.5% meeting the recommended daily physical activity.

Physical Activity Alliance, The 2022 United States Report Card on Physical Activity for Children and Youth

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Prior to the enactment of HB-131, the majority of New Mexicans with limb loss, limb difference, and mobility impairment faced difficulties in obtaining affordable and accessible prosthetic and orthotic care for physical activities and exercise because state, federal, and private health plans deem this care “not medically necessary.”

Without health plan coverage, adults, children, and families are forced to:

Incur prohibitive out-of-pocket costs (ranging from $5,000 -$50,000)
Risk harm/injury using an improper device
Live socially isolated and sedentary lifestyles with costly health complications including obesity and depression

HB-131 will now ensure New Mexicans with disabilities that are covered by state-regulated commercial insurance plans and state employee plans have access to all facets of society including physical activity and exercise through coverage of recreational prostheses and orthoses. Help us get the word out and maximize the positive impact of this new law for the disability community in New Mexico!

What does HB-131 do?

This bill requires state employee plans to provide coverage and reimbursement for O&P care at a level that is equivalent to the federal Medicare program (also known as “insurance fairness or parity”). It also requires state commercial plans to provide coverage for an additional prosthetic or custom orthotic device for physical activity. The bill defines nondiscrimination standards, prohibits unfair trade practices, exempts reasonable useful lifetime restrictions, and deems O&P care as an essential health benefit.

How HB 131 Benefits New Mexico

This bill ensures every New Mexican covered by a state employee plan or state commercial plan with limb loss, limb difference, or mobility impairment will have access to the prosthetic and orthotic care they need to move.

Inspiring Narratives from New Mexico

Callaway (11), an avid climber, was bouldering in the Sandia Foothills with her family when some boulders shifted, and she became pinned between two. In total, Callaway escaped with 22 injuries, eventually resulting in the amputation of her lower foot and leg. She continues to live life with a can-do attitude towards all things because of her access to prosthetics. In addition to her everyday walking prosthesis, she has a prosthesis for running and one for climbing.

Callaway Lewis

Albuquerque, NM

Callaway Lewis

Albuquerque, NM

Inspiring Narratives from New Mexico

Born into the world with hip-level limb loss, Hope (7) has found every opportunity to beat all odds and conquer each challenge that she has faced. With only her left leg, Hope has found much joy and success in ballet, playing with her peers and finding new ways to experience everyday activities. However, her everyday prosthesis is made only for walking and is not designed for running. “I want a running leg so I can catch up with my friends at school … and so I can run fast with my friends,” Hope shared. Because of her advocacy, Hope recently received her first running prosthesis!

Hope Burnett

Albuquerque, NM

Hope Burnett

Albuquerque, NM

Inspiring Narratives from New Mexico

Julie Jordan is a physical therapist and full-time faculty member at UNM School of Medicine. While biking to work in 2014, she was run over by a garbage truck which resulted in many injuries including the amputation of her right leg above the knee. Since then, she has been committed to staying active and participates in many athletic endeavors such as rock climbing, bicycling, downhill skiing, running, and swimming. She also enjoys activities with her family and friends which include hiking, playing ping pong, dancing, and walking. Julie has access to activity-specific prostheses for running and rock climbing, without which she would not be able to participate in these sports. Julie competed in the USA Paraclimbing National Championships in 2021. She wears her daily functional prosthetic leg for 14 to 16 hours a day, which enables her to work full time and continue with most activities of daily living with minimal modifications.

Julie Jordan

Albuquerque, NM

Julie Jordan

Albuquerque, NM

Inspiring Narratives from New Mexico

Kyle is a born and raised New Mexican. When he was 14 years old he was diagnosed with stage 4 osteosarcoma, bone cancer. After chemo he opted for an internal prosthetic – to save his leg, and his life – but the steel implant made him vulnerable to injury. Two years ago, while downhill mountain biking in Angel Fire, he crashed and shattered the metal. He then underwent an above-knee amputation and would need an external prosthetic. Almost immediately, his insurance denied him the prosthesis he needed – a microprocessor controlled knee (MPK) – to prevent falls and regain his mobility. After countless denials and appeals, his case was eventually overturned by the New Mexico Office of Superintendent of Insurance. Now, in addition to his MPK, Kyle has access to a prosthesis for running and has been able to compete as an elite paratriathlete. Thanks to Kyle’s leadership in New Mexico, HB-131 will ensure all New Mexicans have the right to move.

Kyle Stepp

Albuquerque, NM

Kyle Stepp

Albuquerque, NM