Idaho House introduces bill to cut Medicaid expansion costs — without repeal trigger

Yahoo

25-02-2025

A person stands in front of the Liberty Bell replica at the Idaho State Capitol building in Boise on Jan. 11, 2023. (Otto Kitsinger for Idaho Capital Sun)
A North Idaho lawmaker pushing for Medicaid expansion reform introduced a new bill meant to contain expansion's costs — without the threat of repealing the voter-approved law.
The Idaho House Health and Welfare Committee on Tuesday introduced the new bill, House Bill 328, by Rep. Jordan Redman, R-Coeur d'Alene.
Dubbed the 'Medicaid Reform and Cost-Containment Act,' the bill doesn't include many of the 11 policy changes a previous Medicaid expansion reform-or repeal bill by Redman demands to avoid triggering the repeal of Idaho Medicaid expansion. That bill narrowly passed the full Idaho House last week.
But the new bill proposes Idaho submit to the federal government a plan for 'comprehensive medicaid managed care,' which is when private companies manage Medicaid benefits, and end Idaho's use of doctor-managed care, which is commonly called value based care.
Introducing the new bill in committee, Redman said the bill is based on feedback to Redman's previous Medicaid expansion reform-or-repeal bill and has been worked on since that other legislation passed the Idaho House.
'This is part of a negotiation between myself, the good chairman, and Senate leadership to bring forward a path for meaningful Medicaid reforms,' Redman told the House Health and Welfare Committee.
He also told the committee that the bill was not responding to any threats. On Saturday, the Coeur d'Alene Press reported that local police were investigating a threat against Redman's office that originated on social media.
The new bill is cosponsored by the chairs of the Legislature's Health and Welfare committees, Rep. John Vander Woude, R-Nampa, and Sen. Julie VanOrden, R-Pingree, along with Sen. Carl Bjerke, R-Coeur d'Alene.
The bill could save Idaho $15.9 million in fiscal year 2026 and even more in the future, the bill's fiscal note estimates. But the timing depends on federal approval, the fiscal note says.
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Redman told the committee the new bill doesn't include several of the policy changes from his reform-or-repeal bill, like the three-year cap on Medicaid expansion enrollment, capping expansion enrollment at potentially less than half of the current almost 90,000 enrollees — and the Medicaid expansion repeal trigger if all 11 policy changes were not implemented.
Redman's new, complex Medicaid cost-containment bill proposes a range of other program policy changes — including work requirements for able-bodied adults enrolled in Medicaid expansion, which is also in his reform-or-repeal bill. The new bill also calls for Idaho to seek federal approval for 'participant cost-sharing,' submit a plan for 'comprehensive Medicaid managed care,' and stop contracting with and reimbursing Idaho's value care program by Jan. 1, 2026.
Similar to a provision in Redman's previous bill, the new bill has a provision to address if the federal government reduces its financial matching rate for Medicaid expansion, which is 90% compared to Idaho's typical federal Medicaid match rate of 70%.
If the federal financial participation rate in Medicaid expansion reduces outside of a state legislative session, the bill directs the Idaho Department of Health and Welfare to 'take any action necessary to offset the increase in state funding,' such as by cutting optional benefits or reducing provider payment rates.
In an interview after the committee meeting, Redman told the Idaho Capital Sun his Medicaid expansion reform-or-repeal bill, House Bill 138, is still active this legislative session.
'It's still sitting over in the Senate. However, meeting with the Senate leadership … it's going to be a hard lift for them, so we decided to bring this bill' so they can have a choice, Redman told the Sun.
He said he believes House Bill 138 is awaiting scheduling for a committee hearing in the Senate while lawmakers wait 'to see what happens with this one.'
Redman said he thinks the expansion repeal trigger in his previous bill was the biggest concern to Senate leadership, but he said they were also concerned about the enrollment cap and lifetime limit.
In a text message Tuesday, Senate Health and Welfare Committee Chairwoman VanOrden told the Sun that the Medicaid reform-or-repeal bill 'will be staying at my desk for now.'
'I appreciate the work my colleagues in the House have done to contain costs and protect Idahoans from the growing burden of abuse and fraud. I also have heard the concerns from many of you about the full repeal of Medicaid expansion,' she said. 'Working closely with Chairman Vander Woude and Representative Redman, as well as Vice Chair Bjerke, we have introduced a new bill that will ensure access to healthcare in rural Idaho and implement reforms that Medicaid desperately needs.'
In a statement, American Cancer Society Cancer Action Network Government Relations Director Randy Johnson celebrated 'the defeat' of the Medicaid expansion reform-or-repeal bill, but expressed concern about the new bill.
'The defeat of HB 138 is a critical victory for Idahoans who rely on Medicaid Expansion for life-saving care, including cancer patients and those with chronic illnesses,' Johnson said in a statement. 'However, we remain deeply concerned about the remaining waiver proposals in (the new bill) that would impose unnecessary red tape and bureaucratic hurdles, ultimately leading to health coverage losses for hard-working families.'
The Idaho House Health and Welfare introduced Redman's new bill with little discussion. Introducing the bill tees it up for a full committee hearing, with public testimony and a possible vote to advance it to the House floor.
To become law, Idaho bills must pass the House and Senate, and avoid the governor's veto.
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