A proposed law to add a three-month employment verification for low-income residents seeking health care coverage through Idaho’s Medicaid expansion program sailed through the Senate on Tuesday to head to the governor’s desk.

Nearly 80,000 Idahoans rely on the government-subsidized program for health insurance. But state lawmakers estimate a quarter to half of current enrollees — as many as 40,000 people — would be thrown off the Medicaid expansion under the requirements in House Bill 913 and forced to find coverage another way, or go without.

“We want to make sure that somebody just doesn’t go out and get a job two weeks or three weeks before they apply to qualify,” bill sponsor Sen. Julie VanOrden, R-Pingree, said on the Senate floor. “We want to be able to look back three months to make sure that they have been working or doing the activities that are required under this.”

With a 29-6 vote, the bill split along party lines in the Senate. No Republicans voted against it. In the House, one GOP member joined Democrats in opposition when it passed earlier in March.

Eligibility for the state’s Medicaid expansion already maintains a yearly income cap for an individual at approximately $22,000. For a family of four, annual earnings can’t exceed about $45,500, under the guidelines.

If the new bill becomes law, to apply or keep health care coverage, a person must work or volunteer at least 80 hours per month, and have proof they’ve done so for the prior three months. The Idaho Department of Health and Welfare, which administers the Medicaid expansion, would be tasked with conducting the review of all of its recipients by the end of the year.

After consecutive years of other legislation that sought an outright repeal of the Medicaid expansion over rising expense to taxpayers, the work requirements bill was branded a compromise to rein in costs. The federal government covers 90% of the program, and the state the remainder.

Gov. Brad Little has previously said he would not support a full-blown repeal. Idaho voters approved the Medicaid expansion in 2018 through a ballot initiative.

But opponents, including House Minority Leader Melissa Wintrow, called the Legislature’s action a “backdoor repeal.” They also pointed to other states with a one-month requirement rather than the longer one permitted under the One Big Beautiful Bill Act passed last year.

“If we really want to help working-class families, we would not do anything to risk folks coming off Medicaid expansion,” Wintrow, D-Boise, said during floor debate. “And I do think this is a backdoor way to try to repeal, because when you increase the red tape, the administrative burdens, it means that more people won’t be able to apply or be on the program.”

Immediately following Senate passage, the American Cancer Society Cancer Action Network called on Little to veto the bill.

“HB 913 will not reduce costs in a meaningful way and will make the program harder for the state to manage,” Randy Johnson, the nonprofit’s government relations director for Idaho, said in a statement. “It adds red tape that will strip eligible individuals of their coverage, and we’ve seen firsthand how bureaucratic hurdles cause people to lose coverage — not because they are ineligible, but due to unnecessary administrative obstacles.

“Medicaid expansion is a lifeline for tens of thousands of Idahoans, and this legislation takes it away from many, which seems to be the unfortunate goal of this Legislature.”

Earlier in the day, the House narrowly approved the state’s overall Medicaid budget for fiscal years 2026 and 2027. It previously passed the Senate, and now also goes to Little for consideration. Fiscal year 2026 totaled about $5.3 billion, while appropriations for 2027 were set at almost $5.5 billion.

On average, the federal government pays roughly 70% of the total cost of the overarching Medicaid program in Idaho, which includes the expansion.

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