State legislators will get another look at a bill that could repeal Idaho’s Medicaid expansion program if certain restrictions aren’t met.
“This legislation provides safeguards to Idaho’s Medicaid program ensuring its sustainability, prioritizing resources for needy populations and promoting fairness and accountability,” said Rep. Jordan Redman (R-Coeur d’Alene), the bill’s sponsor.
Redman introduced a similar measure last year, which includes work requirements, a three-year lifetime limit on health benefits and an overall enrollment cap of 50,000 people or fewer.
As of Dec. 31, 2024, nearly 90,000 people enrolled in Medicaid expansion according to state health officials.
House Bill 138 would also require the Idaho Department of Health and Welfare to keep improper payments below 5% and the federal government couldn’t reduce its share of the costs below 90%.
House Minority Leader Ilana Rubel (D-Boise) said those requirements essentially spell the end Medicaid expansion in Idaho.
“I think this will, for all practical purposes, mean Medicaid expansion repeal because some of these waivers we’ve asked for in the past and they’re not possible to grant in compliance with the Affordable Care Act,” Rubel said.
The Biden administration did not approve prior waivers submitted by the state to include work requirements and other conditions.
But Redman said he’s confident the Trump administration will sign off on them.
“The goal is that we would hit these safeguards and it saves the state more money to keep [Medicaid expansion],” he said.
If signed into law, the state would have until July 1, 2026 to meet these requirements or the program would shutter by Oct. 1, 2026.
If at any time the state falls out of compliance with the bill after it’s passed, Medicaid expansion would be eliminated within 90 days.
Rep. Megan Egbert (D-Boise) joined Republicans in voting to introduce the bill in the House Health and Welfare Committee Tuesday, saying she wants to ask further questions about the proposal.
That same committee introduced House Bill 58 last month, which would simply repeal Medicaid expansion.
Copyright 2025 Boise State Public Radio