by Logan Finney, Idaho Reports
Lawmakers on the House Health and Welfare Committee introduced legislation on Monday that would effectively repeal expanded Medicaid coverage in 2025 if certain requirements are not met.
Another bill would create a direct pathway for medical school graduates in Idaho to earn a license without entering a medical residency program.
Medicaid Expansion
Lawmakers are keen to get a handle on the state’s Medicaid budget this session.
“We all are very well aware that our Medicaid budget last year was the largest budget that the state has ever passed,” said Rep. Jordan Redman, R-Coeur d’Alene. “This bill is geared to offer both oversight and accountability and curb fraud, waste and abuse within our Medicaid system.”
House Bill 419 would add several requirements to state code that must be met by July 1, 2025, for Medicaid Expansion to stay in place.
The existing federal funding commitment must remain at 90%, and individuals with adjusted gross income above 100% of the federal poverty level must have the option to take the advance premium tax credit and purchase a plan on the state health insurance exchange.
The legislation would also place an enrollment cap on Medicaid Expansion. It would limit the program to cover either 50,000 people or the number of Idahoans over age 65 or with a disability who have regular Medicaid coverage, whichever is lower.
The bill would also require the Idaho Department of Health and Welfare to maintain a Medicaid improper payment rate of 5% or less, implement a lifetime benefit limit of 36 months, suspend or limit several eligibility assumptions, and implement work requirements at 20 hours per week for able-bodied adults.
Gov. Brad Little’s budget proposal this year includes work requirements for able-bodied adults on Medicaid Expansion, which would need a federal waiver, according to reporting by the Idaho Capital Sun.
The bill also forbids use of Medicaid funds to pay for “any gender reassignment procedures, including treatments or surgeries” whether for adults or minors.
If the conditions in the bill were not met, the legislation would require the Department of Health and Welfare to terminate expanded Medicaid eligibility within 90 days.
“The requests in this bill are very attainable from the department and should ensure that our Medicaid program is serving those who are truly in need for many years to come,” Redman said.
The bill’s fiscal note estimates about $163 million in savings – about $136 million from reducing improper payments and $27 million from capping total enrollment – or $109 million in savings if the requirements were not met and Medicaid Expansion was effectively repealed.
Physician Licensure
Lawmakers also introduced House Bill 418 that would expand the “bridge year physician” program.
House Bill 153 last session established a one-year limited medical license for first-year medical school graduates who have applied to but not been accepted to a medical residency program. By allowing graduates to practice under the supervision of a licensed physician, the law was intended to help address the state’s physician shortage.
The bill introduced on Monday would change that designation from “bridge year physician” to “assistant physician” and expand it to a three-year, renewable limited license.
“The goal of this legislation is to relieve the bottleneck that we’re currently seeing in the state of Idaho for new positions, getting into the field faster,” Redman said.
Under the bill, an assistant physician in good standing would be eligible to become a licensed general practitioner in Idaho by completing 36 months of collaborative practice and at least 50 hours of continuing medical education, or by completing the U.S. medical licensing exam.
The introduced bills must return to committee and receive a full public hearing to move forward.
Logan Finney | Associate Producer
Logan Finney is a North Idaho native with a passion for media production and boring government meetings. He grew up skiing, hunting and hiking in the mountains of Bonner County and has maintained a lifelong interest in the state’s geography, history and politics. Logan joined the Idaho Reports team in 2020 as a legislative session intern and stayed to cover the COVID-19 pandemic. He was hired as an associate producer in 2021 and they haven’t been able to get rid of him since.