BOISE, Idaho — A bill that would set conditions for Medicaid expansion passed the Idaho House of Representatives on Wednesday with a vote of 39 in favor and 31 against. House Bill 138, brought forward by Representative Jordan Redman, aims to scale back Medicaid expansion, citing financial concerns and the necessity for program integrity.
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The bill introduces several conditions that must be met to continue Medicaid expansion in Idaho. These conditions include maintaining a 90% federal financial participation rate and implementing work requirements for able-bodied adults. Additionally, it sets an enrollment cap of 50,000 individuals, or the total number of adults already enrolled in Medicaid who are disabled or over 65, whichever is lower.
Representative Redman emphasized the financial implications of the current Medicaid system, stating, “Medicaid is eating up about 30% of our state budget currently. It’s grown significantly since the early 2000s... There’s far too much waste. There’s far too much fraud.” He argued that the bill will keep Medicaid sustainable by reducing improper payments, reinforcing work requirements, and focusing funds on the most vulnerable populations.
However, opponents of the bill have raised significant concerns. Representative Healey from District 15 stated, “We are literally putting Idahoans in the life of our federal government. We've sat here and we worked to take everything back from the federal government... But here we are, just handing it back to our federal governments..”
Moreover, Representative Erickson stressed the importance of prioritizing patient outcomes over budget concerns. He remarked, “These people on the ground in Idaho should always be our top priority, not our state budget.”
Opponents also argue that the bill could force tens of thousands of Idahoans to lose health coverage, especially those battling serious illnesses. As Randy Johnson with the American Cancer Society noted, “11,800 Idahoans are going to hear ‘you have cancer’ this year alone, and we want to ensure they won’t have to worry about treatment or paying for groceries.”
House Bill 138 stipulates that Medicaid expansion would only continue for adults under 65 years old, whose adjusted gross income is at or below 133% of the federal poverty level if the above conditions are met by July 1, 2026. If the conditions are not met, the expansion would be terminated. The bill now moves to the Senate for further consideration.
