BOISE, ID – A bill headed to the Idaho House calls for the state to implement Medicaid work requirements for adults enrolled in Medicaid expansion by the end of the year.

The Idaho Legislature has called for able-bodied adults on Medicaid expansion to prove they are working to receive benefits through the public assistance program before. But those rules need approval from the federal government, which is often a lengthy process that Idaho hasn’t succeeded with.

But House Bill 913 proposes adopting Medicaid work requirements that were part of President Donald Trump’s cornerstone law, the One Big Beautiful Bill Act. Rep. John Vander Woude, a Nampa Republican who’s behind the Idaho bill, hopes the state wouldn’t need federal approval for this iteration of work requirements.

He called for a staggered approach to implementing the work rules. The Department of Health and Welfare could do an early review later this year, before the work requirements officially take effect in January. Vander Woude says that approach would give people time to fix their work status to remain on the program.

“This bill actually accomplishes what we’re trying to do without disrupting those who should be still on,” Vander Woude told lawmakers on Friday.

The House Health and Welfare Committee voted to advance the bill to the full House on Friday. The committee’s two Democrats opposed it.

“I feel like this bill is really designed to maximize the number of people who trip up and don’t meet the paperwork requirements,” said House Minority Leader Ilana Rubel, a Boise Democrat.

Idaho Medicaid expansion covers nearly 79,000 Idahoans.

Vander Woude estimated around 15,000 or 20,000 people could be removed from Medicaid under the work rules, but said he isn’t sure. Rubel said a third to half of people on the program would likely be kicked off.

What would the Medicaid work requirements look like?

Idaho governor signs bill to privatize management, add work requirements to Medicaid program

The bill calls for Idaho to adopt by Dec. 31, 2026, Medicaid work requirements included in the One Big Beautiful Bill Act. The federal law required the work requirements to take effect by 2027.

The federal law’s work requirements will require that people enrolled in Medicaid expansion work or do community service at least 80 hours per month, according to health policy research group KFF. Several exemptions would apply, such as for people who are:

• medically frail;
• enrolled in school at least half time;
• caretakers or parents of dependent children younger than 13 years old or people with disabilities;
• pregnant or receiving postpartum coverage;
• veterans with disabilities;
• and those under age 26 who are or were in foster care.

The Idaho bill would require that people comply with the work requirements for three months before they apply to Medicaid. The Idaho Department of Health and Welfare would remove “any person … who is unable to demonstrate compliance” from Medicaid.

If passed into law, the bill would take effect immediately.

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