Idaho Legislature: Ask Legislators to VOTE YES on H0138 - Medicaid expansion, conditions (posted 02/24/25, updated 03/06/25)

• Bill: legislature.idaho.gov/s…

• Contact Legislators: emailidaho.com

(Check the linked page or use My Bill Tracker for the bill’s current status.)

__________

Medicaid Expansion was a misleading ballot initiative that become law and ended up costing an unexpected arm and leg.

The Medicaid behemoth grows in size, scope, and spending, while increasing dependence on government, reducing incentives to provide quality care, and forcing private competitors out of the market. Medicaid and Medicaid expansion are among the largest and most expensive government programs and among the largest ongoing drivers of federal debt.

• About 90% of Idaho’s Medicaid comes from federal dollars.

• As Medicaid grows, federal dollars become a growing share of Idaho’s budget.

• Federal dollars come with strings that require Idaho to comply with policies and priorities that may not match Idaho’s values and best interests.

• Idaho’s Medicaid expansion costs more than tripled, increasing from $403 million in FY21 to over $1.36 billion estimated for FY26.

• If nothing changes, Medicaid likely will prevent funding for priorities like schools, roads, and law enforcement.

Reasons to Support:

• Focuses Medicaid on those who need it most.

• Does not affect coverage for vulnerable groups like the elderly, disabled individuals, pregnant women, children, and most parents and caretakers.

• Targets reforms toward able-bodied, childless adults, who make up the largest cost driver in Medicaid expansion.

Key Provisions:

• Funding: Medicaid expansion allowed only if federal funding remains at 90%.

• Work: Able-bodied adults must work, train, or volunteer at least 20 hours per week (similar to other Idaho welfare programs).

• Caps: Able-bodied adult enrollees cannot exceed the population of seniors or individuals with disabilities, prioritizing the most vulnerable.

• Payment Controls: The Department of Health and Welfare must reduce improper Medicaid payment rates to 5% or less.

• Reviews: Enrollee eligibility will be reviewed biannually.

• Time-Limits: Able-bodied adults subject to three-year lifetime limit on Medicaid benefits.

• Private Coverage: Enrollees above 100% of the federal poverty level may choose federally subsidized private health insurance.

References:

• What to Do about Medicaid. By Brian Almon (03/06/25): tinyurl.com/2vj58srn

• US Constitution: constitutioncenter.org/…

• Medicaid Expansion (shortened URLs):

  Ballotpedia: tinyurl.com/mryamtd9

  S1204 (2019): tinyurl.com/3k3kkfjc

• Idaho Freedom Foundation House Bill 138 — Medicaid expansion, conditions (+5): idahofreedom.org/house-…

• Related Note about H0138 and H0345: tinyurl.com/yckesu3t