Bill awaiting Governor’s signature would create the strictest Medicaid Expansion requirements in the US
By: Sahana Patel
Posted 7:19 PM, Apr 02, 2026
BOISE, Idaho — A bill sitting on Gov. Brad Little’s desk could make Idaho’s Medicaid expansion requirements the strictest in the country.
House Bill 913 would require people on Medicaid expansion to prove they have met work requirements over a three-month period.
Randy Johnson, government relations director for the American Cancer Society Action Network, said the bill would be among the strictest in the nation if signed.
"The parameters aren't even established yet, and so there's already confusion about what people are going to have to [do] to put in the paperwork," Johnson said. “Idahoans are going to lose their health insurance from this bill, not because they're not eligible, but because of not being able to fill out the paperwork.”
Randi LaSalle, a former Medicaid expansion recipient, worries that tightening access could do more harm than good and cause instability for families.
"We're not asking for Medicaid to be selfish. We're asking for Medicaid to be healthy and sustainable," LaSalle said.
During the COVID-19 pandemic, LaSalle and her family qualified for Idaho’s Medicaid expansion program. The program provides coverage for adults who earn too much to qualify for traditional Medicaid but still cannot afford private insurance. LaSalle said having that coverage made a critical difference for her son.
"He was already in sepsis, and he was 3 weeks old, and we had no idea. The only way I felt comfortable going was because we had Medicaid; had we had private insurance, I might have second-guessed it," LaSalle said.
Two years later, LaSalle said her family was suddenly cut off from the program, even though she said their financial situation had worsened following the pandemic. She believes outdated income information may have played a role.
"They never reevaluated us. They didn't give us a notification. They didn't call us, they didn't email us, nothing, and we were just dropped," LaSalle said.
The then-single mother of four said she turned to private insurance to keep her children covered, paying close to $1,000 a month.
"I got a 3rd job. I would work eight hours in a day. Two days a week, I would clean the offices that I worked for, and then at night I would drive for DoorDash,” LaSalle said. “I didn't want to lose my kids because I couldn't feed them.”
LaSalle said she is worried other families could face the same kind of instability if the bill becomes law.
"You know, we don't need handouts. We don't. We need people to just understand what it's like. Not to be poor, but to be that family who's trying and can never catch a break,” LaSalle said. “Not having to pay for insurance at $1100 a month or $900 a month or however much it's going to cost you, that's something that can go back towards the family.”
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