Vote Smart's Synopsis:

Vote to pass a bill that requires policy changes to state Medicaid in Idaho.

Highlights:

• Prohibits any state plan to expand medicaid eligibility on and after July 1, 2026 (Sec. 1).

• Requires federal financial participation remains at 90 percent of the federal commitment level (Sec. 1).

• Requires able-bodied participants work, volunteer, participate in a work-fare program, or a combination of any of those three activities for at least 20 hours per week, unless the participant is (Sec. 1):

• Younger than 19 years old;

• Older than 64 years old;

• Medically certified as physically or mentally unfit for employment; 

• Pregnant; 

• A parent or caretaker responsible for the care of a dependent child younger than 6 years of age;

• A parent or caretaker taking care of a dependent child with a serious medical condition or with a disability;

• Receiving unemployment compensation and complying with work requirements as part of the federal-state unemployment compensation system; or

• Participating in a drug addiction or alcohol treatment and rehabilitation program.

• Requires persons eligible for medicaid to receive a tax credit to purchase a qualified health insurance plan through the Idaho health insurance exchange, if requested (Sec. 1).

• Establishes an enrollment cap of 50,000 individuals or the total number of people 65 years of age or older and disabled individuals (Sec. 1).

• Requires the improper payment rate to remain under 5 percent (Sec. 1).

• Prohibits the automatic renewal of eligibility using pre-populated forms and available information (Sec. 1).

• Establishes a lifetime benefit limit of 36 months (Sec. 1).

• Requires a biannual redetermination of eligibility for participants in the Medicaid program (Sec. 1).

• Requires limited hospital presumptive eligibility determinations to children and pregnant women (Sec. 1).

• Prohibits the use of Medicaid to fund procedures related to gender-affirming care for children (Sec. 1).

• Prohibits use of Medicaid to fund gender reassignment procedures (Sec. 1).

• Requires any state plan amendments or waiver requests necessary to implement the provisions of this legislation to be submitted to the U.S. Department of Health and Human Services by October 1, 2025 (Sec. 1).

• Requires notification of the state senate and the state house of representatives health and welfare within 30 days of any updates on federal waiver or state plan amendments submitted in reference to this bill (Sec. 1).

• Requires individuals no longer eligible to receive Medicaid based on the provisions of this bill to have their insurance rescinded by October 1, 2026 (Sec. 1).

• Specifies that American Indians and Alaskan natives who are eligible for services through the Indian health service or tribal programs are exempt from the provision of this bill (Sec. 1).

• Specifies that this bill is effective on July 1, 2025 (Sec. 2).

Full Bill Text