MEDICAID – States findings of the Legislature and calls on the U.S. Department of Health and Human Services to review and expeditiously approve pending Medicaid waivers.

68th Legislature, 1st Regular Session (2025)

Idaho urges federal approval of four 2019 Medicaid waivers to maintain its chosen restrictions (family planning, substance treatment, work/education, exchange-first).

Reported Printed and Referred to Health & Welfare

#federallawsandrelations #government #healthandwelfaredepartment #medicaid #memorials

Overview

Bill: HJM 7 — Joint Memorial urging expedited federal action on Idaho’s pending Medicaid waivers.

Classification: Memorial (joint memorial by House and Senate).

Introduced: March 6, 2025; First Regular Session, 68th Legislature.

Status: Reported Printed and Referred to Health & Welfare (after referral from JRA for printing).

Subject: Federal laws and relations; Health and Welfare Department; Medicaid; Memorials.

Purpose and Intent

The memorial reaffirms Idaho’s commitment to the four policy modifications Idaho enacted in 2019 under Chapter 318 (Laws of 2019) to the state’s Medicaid expansion.

It asks the federal government (specifically the Centers for Medicare and Medicaid Services and the Secretary/Acting Secretary of the U.S. Department of Health and Human Services, plus the President) to review and expeditiously approve Idaho’s four pending waivers submitted in 2019.

The memorial explicitly states Idaho’s support for the 2019 waiver-based restrictions as the preferred way to operate the state’s Medicaid program.

Key Provisions and Provisions’ Effect

Reaffirms Idaho’s policy framework from Chapter 318, Laws of 2019, which modified Medicaid expansion with four restrictions:

Family planning
Alcohol and drug treatment
Work or educational requirements
Rules preferring newly eligible recipients to first apply for public assistance through Idaho’s health insurance exchange

Calls on the U.S. Department of Health and Human Services to review and expeditiously approve the still-pending 2019 waiver submissions.

Directs the Chief Clerk of the Idaho House to transmit copies of the memorial to:

President of the Senate and Speaker of the House (Congress)
Idaho’s congressional delegation
Secretary or Acting Secretary of HHS
The President of the United States

No new state law is enacted; this is a symbolic, policy-persuasion act aimed at federal action.

Who Is Affected

State government: Idaho Department of Health and Welfare (IDHW), which prepared and submitted the waivers in 2019.

Medicaid recipients in Idaho: Potential beneficiaries of the four waivers if approved.

Idaho taxpayers: Potential long-term fiscal impact depending on waiver approval and program design.

Federal agencies: CMS and HHS, which would review/approve the waivers.

Idaho’s elected representatives: The memorial channels requests to federal officials.

Fiscal and Procedural Context

Fiscal Note: No direct fiscal impact from the memorial itself; potential substantial savings to taxpayers if waivers are approved and implemented successfully.

Legislative Actions:

2025-03-06: Introduced, read first time, referred to JRA for Printing.
2025-03-07: Reported Printed and Referred to Health & Welfare.

Nature of bill: This is a memorial, not a binding statute; its effect is to advocate for federal action and reaffirm state policy preferences.

Potential Impact and Considerations

If federal waivers are approved, Idaho could implement the four restrictions while continuing its Medicaid expansion, potentially affecting eligibility processes, provider networks, and recipient requirements.

The memorial frames federal inaction since 2019 as a violation of the state’s policy choices and the spirit of state sovereignty, while seeking to align federal action with Idaho’s chosen policy framework.

The bill does not specify new funding or enrollment changes; any fiscal impact would depend on the eventual waiver terms and federal/state implementation.

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