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Bill

H 328

MEDICAID – Amends, repeals, and adds to existing law to provide that legislative approval is required for certain state plan amendments and waivers and to provide legislative approval for certain state plan amendments and waivers.

68th Legislature, 1st Regular Session (2025)

House Bill 328 requires legislative approval for Medicaid changes, ensuring fiscal responsibility and protecting rural healthcare access while saving the state millions.

Reported Printed and Referred to Health & Welfare
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Bill Summary · H 328

Summary of House Bill 328 (H 328)

Purpose and Intent

House Bill 328, introduced on February 25, 2025, aims to amend existing Medicaid laws in Idaho by requiring legislative approval for certain state plan amendments and waivers. The primary intent of the bill is to enhance oversight of Idaho's Medicaid program, ensuring fiscal responsibility, protecting access to healthcare in rural areas, and implementing safeguards against fraud and abuse.

Key Provisions

The bill includes several significant changes to the Medicaid framework in Idaho:

  1. Legislative Approval Requirement:

    • The Department of Health and Welfare must obtain legislative approval before seeking or implementing any Medicaid state plan amendments or waivers that would:
      • Expand coverage to additional individuals or classes.
      • Increase net costs to the state.

  2. Specific Areas Requiring Approval:

    • Rural Emergency Hospital Designation: Approval is needed for state plan amendments that recognize and reimburse services provided by rural emergency hospitals.
    • Medicaid Cost-Sharing: The bill allows for participant cost-sharing in Medicaid programs, aligning with practices in other states.
    • Comprehensive Medicaid Managed Care: Legislative approval is required for implementing a comprehensive managed care plan.
    • Medicaid Expansion Limits: The bill sets forth work requirements for able-bodied adults enrolled in Medicaid and allows certain individuals to receive advance premium tax credits for health insurance.

  3. Repeal and Amendments:

    • The bill repeals previous provisions related to legislative approval of waivers and state plan amendments and amends various sections of the Idaho Code to reflect these changes.

  4. Administrative Rules:

    • Certain administrative rules will be declared null and void, ensuring that outdated regulations do not hinder the implementation of the new provisions.

Impact

  • Healthcare Providers: The bill is designed to protect critical safety net providers, such as rural emergency hospitals and community clinics, ensuring they can continue to serve vulnerable populations.
  • Cost Management: It aims to contain costs by establishing parameters for Medicaid expansion and implementing cost-sharing measures, which are projected to save the state approximately $15.9 million in FY 2026 and $27.2 million in FY 2027.
  • Legislative Oversight: By requiring legislative approval for significant changes to Medicaid, the bill enhances accountability and oversight of the program.

Procedural Aspects

  • Status: The bill has been reported printed and referred to the Health & Welfare Committee as of February 26, 2025.
  • Implementation Timeline: The Department of Health and Welfare is required to begin the application process for federal approval of necessary state plan amendments by July 1, 2026.

Conclusion

House Bill 328 represents a significant shift in how Idaho manages its Medicaid program, emphasizing legislative oversight and fiscal responsibility while aiming to maintain access to essential healthcare services for its residents.

Compiled from official sources — confirm details with the bill’s official record.

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