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

Additionally, the bill expands Medicaid eligibility for individuals under sixty-five with a modified adjusted gross income at or below 133% of the federal poverty level, requiring the state to submit necessary amendments to the federal government within ninety days of the act's approval. It ensures that Medicaid eligibility will not be delayed by federal waiver approvals and prohibits any waiver that would reduce federal financial participation below 90%. The bill also mandates actions to offset potential reductions in federal funding, which may include reducing provider payment rates or eliminating optional benefits. Certain existing rules related to Medicaid and Medicare benefits will be nullified effective July 1, 2025, and January 1, 2026, respectively, and an emergency clause allows for immediate implementation upon passage.

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