Idaho Lawmakers Enact Medicaid Cuts, Work Requirements

Disability provider pay reductions and strict new Medicaid expansion work rules could push thousands off public health coverage

Apr. 9, 2026 at 8:38pm

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A dynamic, fragmented painting depicting political symbols like a gavel, ballot box, and state capitol building, conveying the complex and contested nature of Medicaid policy changes in Idaho.Idaho's Medicaid program faces an uncertain future as lawmakers impose new work requirements and cut provider pay, sparking concerns over access to care.Boise Today

In the 2026 legislative session, Idaho Republican lawmakers enacted strict new Medicaid expansion work requirements, cut pay rates for disability service providers, and made other budget cuts to the state's Medicaid program - moves that could push tens of thousands of low-income Idahoans off public health coverage.

Why it matters

The changes to Idaho's Medicaid program, including new work requirements and provider pay cuts, reflect a broader conservative push to scale back government health benefits and social services. Critics argue these policies will create unnecessary barriers to accessing care, especially for vulnerable populations.

The details

The Idaho Legislature tacked on strict new work requirements for the roughly 80,000 low-income Idahoans on Medicaid expansion, which researchers estimate could kick tens of thousands off the program. Lawmakers also cut pay rates for providers who care for people with disabilities and extended cuts to Medicaid's already low pay rates for doctors. While a full repeal of Medicaid expansion failed to advance, the new policies are seen by some as a 'backdoor' way to achieve a similar outcome.

  • The new Medicaid work requirements are set to take effect by the end of 2026, unless vetoed by Gov. Brad Little.
  • The cuts to disability provider pay rates will go into effect on July 1, 2027, the start of the next fiscal year.

The players

Mike Moyle

Republican Speaker of the Idaho House of Representatives who signaled openness to repealing Medicaid expansion at the start of the 2026 legislative session.

Julie VanOrden

Republican state senator from Pingree who co-sponsored the Medicaid work requirement bill and said she was surprised a full Medicaid expansion repeal did not advance.

Melissa Wintrow

Democratic state senator from Boise who argued the new Medicaid work requirements are an attempt at a 'backdoor repeal' of expansion.

Jodi New

Owner of Teton Supported Living, a disability services provider who warned lawmakers the pay cuts could force some providers to close.

John Vander Woude

Republican state representative from Nampa and chairman of the House Health and Welfare Committee, who presented the disability provider pay cut bill as an alternative to repealing Medicaid expansion.

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What they’re saying

“The fact that we didn't have a Medicaid expansion repeal bill, and get it passed and get it through was, to me, short of a miracle. Because the topic kept coming up over and over again.”

— Julie VanOrden, Republican state senator

“We are grateful that lawmakers blocked Medicaid expansion repeal, and restored some critical mental health programs, but they also left $239 million unspent while cutting $45 million from Medicaid. That wasn't unavoidable. It was a choice by the Legislature. And in the end, Idaho families and providers are going to feel the impacts of that.”

— Hillarie Matlock, Policy Director, Idaho Voices for Children

“If we can't pay our staff a reasonable wage, we're not going to get good staff. And these participants' lives are in their hands. And that is something that they are not understanding, is that this directly comes out of the direct support staff budgets or what we pay them. And the quality of care goes down, and that's not fair to the participants.”

— Jodi New, Owner, Teton Supported Living

What’s next

The new Medicaid work requirements are set to take effect by the end of 2026, unless Gov. Brad Little vetoes the legislation. Disability providers are bracing for the impact of the pay rate cuts going into effect on July 1, 2027.

The takeaway

Idaho's conservative lawmakers have pushed through a series of changes to the state's Medicaid program, including strict new work requirements and provider pay cuts, that could significantly reduce access to health coverage and services for low-income residents. These policies reflect a broader effort to scale back government-funded social programs, despite concerns they will create unnecessary barriers to care.