The proposed bill amends Idaho's Medicaid regulations by establishing a new chapter that requires legislative approval for specific Medicaid state plan amendments and waivers, particularly those related to rural emergency hospital designations, Medicaid cost-sharing, and Medicaid expansion limits. It repeals existing sections of the Idaho Code concerning legislative approval processes and the powers of the director of the Department of Health and Welfare. Importantly, any Medicaid state plan amendment or waiver that expands coverage or increases costs must receive legislative approval prior to implementation. The bill also clarifies the responsibilities of the Department of Health and Welfare regarding Medicaid managed care and provider payments, while exempting federally qualified health centers from financial risk in certain payment arrangements.

Additionally, the bill amends Section 56-267 of the Idaho Code to expand Medicaid eligibility for individuals under sixty-five with a modified adjusted gross income at or below one hundred thirty-three percent of the federal poverty level, provided they are not eligible for other coverage under the state plan. The Department of Health and Welfare is required to submit necessary state plan amendments to the federal government within ninety days of the act's approval and is authorized to implement these provisions promptly. The bill also includes measures to offset any increase in state funding due to reductions in federal financial participation and nullifies certain rules related to Medicaid benefits and cost-sharing, effective July 1, 2025, and January 1, 2026, respectively. An emergency declaration makes the bill effective immediately upon passage and approval.

Statutes affected:
Bill Text: 56-253, 56-263, 56-265, 56-267