Idaho Bill Proposes Strictest Medicaid Expansion Requirements in US

The proposed legislation would require Medicaid expansion recipients to prove work requirements over a 3-month period.

Apr. 3, 2026 at 1:19am

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A realistic oil painting depicting a lone Medicaid card or medical document resting on a wooden table, bathed in warm, dramatic lighting and deep shadows, conveying a sense of uncertainty and concern over the proposed policy changes.As Idaho considers imposing the nation's strictest Medicaid expansion requirements, the potential loss of coverage could cast a somber shadow over vulnerable families.Boise Today

A bill awaiting the governor's signature in Idaho could make the state's Medicaid expansion requirements the strictest in the country. House Bill 913 would require people on Medicaid expansion to prove they have met work requirements over a three-month period. Advocates warn the bill could cause many Idahoans to lose their health coverage, not because they are ineligible, but because of the burdensome paperwork requirements.

Why it matters

Medicaid expansion has provided critical health coverage for low-income Idahoans, including families struggling during the COVID-19 pandemic. Advocates argue the proposed work requirements could create unnecessary instability and barriers to accessing care, potentially harming vulnerable populations.

The details

The bill would require Medicaid expansion recipients to prove they have met work requirements over a three-month period. Randy Johnson of the American Cancer Society Action Network said the parameters for these requirements are not even established yet, leading to confusion about what people will have to do to maintain their coverage. Randi LaSalle, a former Medicaid expansion recipient, shared her experience of suddenly losing coverage despite her family's worsening financial situation, forcing her to take on multiple jobs to afford private insurance.

  • The bill is currently awaiting the governor's signature.
  • During the COVID-19 pandemic, LaSalle and her family qualified for Idaho's Medicaid expansion program.
  • Two years later, LaSalle said her family was suddenly cut off from the program, even though their financial situation had worsened.

The players

House Bill 913

A bill that would require people on Medicaid expansion to prove they have met work requirements over a three-month period.

Randy Johnson

The government relations director for the American Cancer Society Action Network, who said the bill would be among the strictest in the nation if signed.

Randi LaSalle

A former Medicaid expansion recipient who worries that tightening access could do more harm than good and cause instability for families.

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What they’re saying

“The parameters aren't even established yet, and so there's already confusion about what people are going to have to [do] to put in the paperwork.”

— Randy Johnson, Government relations director, American Cancer Society Action Network

“We're not asking for Medicaid to be selfish. We're asking for Medicaid to be healthy and sustainable.”

— Randi LaSalle, Former Medicaid expansion recipient

What’s next

Governor Brad Little has not yet signed the bill into law. If signed, the new Medicaid expansion requirements would go into effect, potentially leading to many Idahoans losing their health coverage.

The takeaway

This proposed legislation highlights the ongoing debate around Medicaid expansion and the balance between ensuring program sustainability and providing access to critical health coverage for low-income individuals and families. The strict work requirements could create unnecessary barriers and instability, potentially harming vulnerable populations.