(Boise, ID), Boise Lawmakers Push to Repeal Medicaid Expansion, Citing Unsustainable Costs.
Idaho legislators are once again addressing the state’s Medicaid expansion, seeking to repeal the program that currently provides health coverage to around 90,000 Idahoans. Medicaid expansion, approved by voters in 2018, extended coverage to adults who fall in the gap between traditional Medicaid qualifications and the affordability of private health insurance.
Rep. John Vander Woude (R-Nampa) emphasized the need to confront rising costs during Friday’s House Health and Welfare Committee meeting. “We’re on a trajectory that I just don’t think we can afford to continue,” he said. Vander Woude, along with Rep. Josh Tanner (R-Eagle), introduced the repeal bill, which the committee voted to advance along party lines.
While Medicaid expansion has brought federal dollars to Idaho, concerns over its long-term impact on state finances remain a focal point for supporters of the repeal. As of December, the program accounted for 24% of total Medicaid expenditures, costing the state $82.2 million annually in general funds. The overall program cost is approximately $1.1 billion, with most funding coming from federal sources.
Critics of the repeal, including Rep. Ilana Rubel (D-Boise), argue that eliminating Medicaid expansion would harm Idaho’s most vulnerable residents. “Everything I’ve seen indicates that it would actually cost the state more to get rid of Medicaid expansion than it would save,” Rubel said. She also noted the voter-approved program’s popularity, as 60% of Idahoans supported the initiative in 2018.
Medicaid expansion has also reduced the burden on Idaho’s local governments. Prior to its implementation, the state and counties relied on the catastrophic health care program (CAT) to cover indigent medical costs. That program, which has since been scaled back, left counties and hospitals on the hook for significant expenses. Health department data from 2023 estimated that Idaho saved $77 million in costs that would otherwise fall to local entities.
Vander Woude clarified that his bill does not include provisions to restore the CAT fund or any similar safety nets for uninsured residents. Nevertheless, some legislators believe a repeal merits further debate. Rep. Lori McCann (R-Lewiston) expressed concerns about the potential impact on rural areas, but supported advancing the bill to ensure a comprehensive discussion. “I’d like to see an entire economic outlook of what this would do exactly,” McCann said.
Conservative groups have expressed mixed views on Medicaid expansion. While some see it as an unsustainable program that ties Idaho too closely to federal dollars, others worry about the potential financial and social fallout of repealing the program without a replacement.
The American Cancer Society’s Cancer Action Network (ACS CAN) has been vocal in opposing efforts to roll back the program. “There’s no backup plan,” said Randy Johnson, ACS CAN’s government relations representative in Idaho. He warned that repeal would leave thousands without health care options, adding, “The program as it stands is working.”
The repeal bill will now move forward for a full public hearing, allowing Idahoans to weigh in on this critical issue.
