# Idaho Senate Will Consider Medicaid Expansion Work Requirements by 2027
The Idaho Legislature is advancing legislation that could fundamentally reshape the state’s Medicaid expansion program, potentially removing tens of thousands of Idahoans from coverage. House Bill 913, which is now headed to the Idaho Senate for consideration, would establish work requirements for adults enrolled in Medicaid expansion by the end of 2027, according to the bill’s language and legislative analysis. The proposal aligns with federal policy changes in President Donald Trump’s “One Big Beautiful Bill Act” and represents a significant shift in how Idaho administers health coverage for low-income residents—a population that Idaho voters approved for expansion in 2018.
The bill passed the Idaho House on a near party-line vote last week and is heading to the Senate, where it faces its final legislative hurdle before potentially reaching Governor Brad Little’s desk. If enacted, Idaho researchers warn the work requirements could remove up to 44% of the state’s Medicaid expansion population—roughly 34,000 people—from coverage by 2028.
## Background on Idaho’s Medicaid Expansion
In 2018, nearly 61% of Idaho voters approved Medicaid expansion through a ballot initiative designed to close a healthcare assistance gap affecting the working poor. The program has since enrolled approximately 79,000 Idahoans, many of whom work but earn too little to afford private insurance. According to a December report from the Idaho Department of Health and Welfare, about 48% of able-bodied adults on Idaho Medicaid are already employed, raising questions about whether additional work verification mechanisms are necessary.
The expansion has been a cornerstone of healthcare access across Ada County, Treasure Valley communities including Boise, Meridian, Eagle, and rural areas of the state. Hospitals, clinics, and providers have structured services around the expanded enrollment base, making any significant coverage reduction a matter of concern for healthcare administrators and patient advocates.
## How Idaho’s Proposed Work Requirements Would Function
House Bill 913 seeks to adopt federal Medicaid work requirements that were part of Trump’s signature legislation. Under these requirements, able-bodied adults would need to demonstrate they are working, in job training, volunteering, or engaged in other approved activities to maintain Medicaid coverage. Proponents argue the requirements ensure that people receiving public assistance who can work are actually working, promoting self-sufficiency and responsible use of state resources.
However, advocates and researchers warn that work requirements function as administrative barriers rather than true incentives. Many eligible individuals fail to submit required paperwork on time or navigate complex verification systems, even if they are employed. The Urban Institute and Robert Wood Johnson Foundation released an analysis this week projecting that Medicaid work requirements and other changes in federal policy could remove 20,000 to 34,000 Idahoans from coverage by 2028—a swing of 25% to 44% of current expansion enrollment.
## Impact on Ada County Residents and Idaho Families
For Ada County residents and families across Idaho, the potential loss of coverage carries serious consequences. The working poor—people earning just above poverty thresholds but below what’s needed to afford employer health insurance—would face the greatest risk. A single administrative error, a missed deadline, or confusion about documentation could result in coverage loss during a time of medical need.
Healthcare providers across Boise, Meridian, Eagle, and other Ada County communities have already incorporated Medicaid expansion patients into their operational models. Emergency rooms, community health centers, and specialty providers have expanded capacity based on the stable expansion population. A sudden loss of 34,000 covered lives could strain access and shift unpaid care burdens to hospitals and taxpayers.
Additionally, a prior federal watchdog report and experiences in other states indicate that implementing work requirements creates significant administrative costs—expenses that may offset any savings from reduced enrollment. Idaho taxpayers could see little fiscal benefit while vulnerable populations lose healthcare access.
## What Comes Next for Idaho Medicaid Expansion
The Idaho Senate will now consider HB 913, representing the final legislative stop before the bill could reach Governor Brad Little. Senate committees will likely debate the proposal in coming weeks. Residents who want to engage on this issue can contact their state senators through the Idaho Legislature’s website and attend public hearings scheduled in the Capitol in Boise.
Those enrolled in Medicaid expansion should monitor state health department communications for updates on any potential changes to eligibility or documentation requirements.
**Tags:** Idaho, Medicaid Expansion, Healthcare Policy, Idaho Legislature, Ada County