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Medicaid Expansion Under Threat: Total Repeal Proposed
As recently covered in the IMA Legislative Report, a bill has been introduced to entirely eliminate Medicaid expansion coverage, which IMA strongly opposes.
In Idaho, Medicaid expansion provides coverage to non-disabled adults with an annual household income of up to 138 percent of the Federal Poverty Level. Should it be signed into law, HB 850, introduced by Rep. Jordan Redman (R-Coeur d'Alene) would remove coverage for roughly 90,000 Idahoans.
The fiscal note for the bill projects savings of $1.334 billion. However, this figure does not take into account the resulting costs that come with a large population of uninsured individuals, including cost shifting from preventive to more costly emergency and hospital settings. Nor does this account for the loss of productivity in a population that is less healthy due to lack of access to preventive care. According to a Fact Sheet from the Idaho Center for Fiscal Policy, Idaho sees an increase in $1.82 in gross economic activity for every dollar invested in Medicaid.
Idaho voters approved Medicaid expansion in 2018 via a ballot initiative. Previously, thousands of Idahoans were uninsured and fell into the "health care coverage gap." They did not have a health insurance option through their employer, but they earned too much to qualify for traditional Medicaid and too little to qualify for tax credits that make coverage affordable.
After Medicaid expansion took effect, the Idaho Legislature repealed various safety net programs that helped people without insurance pay for emergency care. If Medicaid expansion coverage is eliminated, these programs will need to be funded by the state once more.
Consider the following costs, compiled by Idaho Supports Medicaid:
In FY 2026, the state cost for Medicaid expansion is $91 million. If Medicaid expansion is repealed, it will cost the state general fund more (approximately $143 million) in other programs that would need to be covered with general fund dollars, including:
- Behavioral health, drug courts, Department of Correction, public health, and reinstating the county indigent and state catastrophic care funds ($78 million)
- State Hospital South and State Hospital North ($27.5 million)
- Hospital taxes generated that help cover home and community-based services ($38.3 million)
- Postpartum funding under Medicaid expansion being covered at 90% federal match instead of 70%
Maintaining a strong and stable Medicaid program, including Medicaid expansion, is essential to ensuring Idahoans have access to the care they need. To learn more and to share your perspective on the vital need for this coverage in your community and for your patients, please visit Idahosupportsmedicaid.com/takeaction.
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