Idaho House Committee advances bill to repeal voter-approved medicaid expansion
BOISE, Idaho (KIFI) — In a swift and controversial move, the Idaho House Health and Welfare Committee voted 10–6 on Monday to introduce a bill that would repeal Medicaid expansion, effective January 1, 2028. The decision followed less than 20 minutes of debate centered around rolling back the 2018 voter-approved initiative.
Idaho Medicaid Expansion Background
Idaho voters approved Medicaid expansion through a 2018 ballot initiative. The policy extended Medicaid coverage to Idahoans who earn less than 138% of the federal poverty level, around $22,025 annually for a single person, or $45,540 for a family of four in 2026.
Based on data from the Idaho Department of Health and Welfare, of the 89,000 to 90,000 people on medicaid expansion, 48% were working in 2025. Last year, Governor Brad Little signed into law House Bill 345, requiring Idahoans on Medicaid expansion to prove that they work.
The Argument for Fiscal Control
The bill’s sponsor, Rep. Jordan Redman (R-Coeur d’Alene), framed the repeal as a necessary step recommended by the Idaho Department of Government Efficiency. Redman argued that the program no longer reflects its original intent to provide healthcare to the "working poor" and the most vulnerable due to significant enrollment growth.
"I believe that oftentimes this can actually hold people back from their full potential," Redman told lawmakers, after voicing concerns from employers in his district that workers are turning down raises to avoid hitting the "benefit cliff."
Rep. Lucas Cayler (R-Caldwell) echoed these sentiments, warning that the program would eventually "blow out" the state budget. "There are entirely way too many people—able-bodied adults who are not working—participating," Cayler said. "This is a problem that we need to address now and not kick the can down the road."
The "Will of the Voters"
Opponents were quick to point out the human and democratic costs of the repeal. According to Idaho Voices for Children, the move would leave the approximately 90,000 Idahoans enrolled in Medicaid expansion without health insurance and no clear backup plan.
"Idahoans voted for their neighbors to have healthcare—61% approved Medicaid expansion," said Hillarie Matlock, Policy Director at Idaho Voices for Children. "Ignoring that and taking coverage away goes directly against the will of the voters."
In response to similar concerns brought up in committee, Rep. Redman argued voters did not have accurate information to know how the expansion would affect the state.
The Cost of Medicaid Expansion
While supporters argue the repeal saves the state money, House Minority Leader Ilana Rubel (D-Boise) and financial analysts argue it would actually cost the state in the long run.
Ruble pointed to a study by the Department of Health and Welfare showing $80 million in savings across corrections and behavioral health. Idaho also receives approximately $1 billion in federal funds annually, which support 9000 jobs, Rubel says would be lost without the program.
"I take great issue with the fundamental premise that has brought this, which is this notion that it will somehow save our state money and help our budget," said Rubel. "This would put us in the hole. It would be a net loss of at least $20 million."
According to a study by the Idaho Center for Fiscal Policy, Medicaid expansion also generates neary $47 million in tax revenue for the state, while Idaho’s Medicaid actual expenditures went down by 0.4 percent from FY 2019 to 2024 when adjusted for inflation.
While the projected state cost for Medicaid expansion in FY 2026 is $91 million, Idaho Voices for Children estimates a repeal would actually cost the state $143 million as costs shift back to other General Fund programs.
The bill now moves to the House floor for further debate.
