Divisive Medicaid reform bill heads to the Idaho Senate

BOISE, Idaho (KIFI) - A bill adding requirements to Medicaid expansion is now in the hands of the Senate after passing the House in a 38 to 32 vote Wednesday.

House Bill 138 cleared the floor after nearly ninety minutes of debate. 

Medicaid expansion became law in 2018 with more than 60 percent of voters approving the measure. 

Introduced by Rep. Jordan Redman, R-District 3, House Bill 138 would place 11 additional requirements or policy changes to Medicaid, a federal and state program that assists in covering medical costs for people with lower income and resources.

"House Bill 138, is a bill that restores integrity, financial responsibility, and self-sufficiency back into our Medicaid expansion program," Redman told members of the House.

For the full text and explanation of the bill, click HERE.

Critics warn the bill could repeal Medicaid expansion

If the bill becomes law, voter-approved Medicaid expansion could be repealed if the additional requirements are not met.

Representatives opposed to the bill have argued that the federal government is unlikely to implement all 11 waivers the bill requires.

"I have never seen so much faith placed in our federal government. If we have so much faith that they're going to approve these 11 waivers, I don't understand why we need the trigger. " Rep. Dori Healey, Boise. "...I understand that we need fiscal responsibility, and I think many of these waivers would provide that. [But] I've heard in this body so many times state sovereignty. But here we are just handing it back to our federal government."

Healy argued that the bill was only a convenient way to shift the blame for Medicaid expansion repeal on the federal government, who she says are more than likely not going to approve the additional requirements.

Representatives have also sponsored a separate bill looking to repeal Medicaid expansion directly. Healy argued supporting the alternative bill would be much more honest.

"If we wanted to run a repeal bill, there's a repeal bill in Health and Welfare right now that we could all vote on it," argued Redman. "That's not the intention of this. The intention of this bill is to put accountability back into this program so that we can keep it for the folks who truly need it."

"This is a runaway budget"

The proposed budget for 2026 calls for $1.36 billion for Idaho Medicaid expansion.

"That's almost $1 billion over the projection of what folks voted on when expansion passed," Redman told members of the House. "Medicaid is eating up about 30% of our state budget currently. It's grown, significantly since the early 2000."

Representative Wendy Horman, R-Idaho Falls and co-chair of the House's powerful budget-setting committee argued in favor of the bill. Horman told members of the House that voting "yes" was worth the risk because continuing in the current course leaves the state in a vulnerable position.

"This is a runaway budget," Horman told the House. "It is not sustainable and nothing we have tried so far has worked. I'm willing to take the risk because I think the risk of not acting leaves us in a very vulnerable position to provide essential services to our state, including those most vulnerable who do need medical attention and have no capacity to obtain it for themselves."

Psychologist and former health program manager, Rep. Marco Erickson, R-Idaho Falls, reminded members of the House how Medicaid has impacted the scope of his work and local health providers. He debated that the House needs to focus on the patient's Medicaid impacts first.

"We need to focus on patient outcomes first because the people who are consuming the product are your number one priority," Erickson told members of the House. "These people on the ground in Idaho should always be our top priority, not our state budget."