UPDATE (3/19/25): Gov. Brad Little signed into law new work requirements for able-bodied adults receiving health coverage under Idaho's Medicaid expansion program in a private ceremony with lawmakers Thursday.
"We want Idahoans to become as self-sufficient as possible," Little said in a statement, calling House Bill 345 a "huge improvement" over a prior version that would've likely repealed Medicaid expansion entirely.
"The voters spoke loudly in 2018 with their votes, and as elected leaders we must continue to respect that. I am pleased House Bill 345 improves the Medicaid program without rejecting the will of the voters..." he said.
The Idaho Department of Health and Welfare will work to submit waivers necessary to implement such work requirements to the Centers for Medicare and Medicaid Services, which failed to act on a similar request during the first Trump administration.
ORIGINAL STORY: The latest bill to add work requirements to Idaho’s Medicaid expansion program is heading to the Senate.
House Bill 345 easily cleared the House Thursday along party lines with little debate.
Rep. Jordan Redman’s (R-Coeur d’Alene) newest proposal largely focuses on requiring participants to work, study or volunteer for 20 hours per week to qualify.
“Medicaid expansion was brought into place for the working poor. Right now, we have 47% of them not working,” Redman said.
House Democratic Leader Ilana Rubel (D-Boise) says the bill’s monthly reporting rules are too onerous. She also points out parents with children ages six or older would have to meet these work requirements.
“This basically strips out the ability for those at home and homeschooling to remain on Medicaid without having to be out in the workforce and reporting,” Rubel said.
Redman’s prior bill, House Bill 138, would’ve repealed Medicaid expansion if the state didn’t get approval from the federal government on several conditions.
Those include adding a lifetime eligibility limit and capping the number of current participants. In all, 10 of the 11 requirements listed in HB 138 would’ve needed federal approval.
HB 345’s fiscal analysis said the measure would save Idaho nearly $16 million the first year it’s implemented. It projects $27.2 million annually for each of the following years.
Redman said those savings will also come from switching to a managed care scheme, which would allow the state to negotiate contracts with other organizations to deliver care.
But opponents say the state would lose money because it’ll need to hire new staff to track the monthly work reporting requirements.
The bill now goes to the Senate.
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