Amends existing law to revise provisions regarding Medicaid eligibility expansion.

LEGISLATURE OF THE STATE OF IDAHO Sixty-eighth Legislature Second Regular Session - 2026 IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 913 BY WAYS AND MEANS COMMITTEE AN ACT1 RELATING TO MEDICAID; AMENDING SECTION 56-267, IDAHO CODE, TO REVISE PROVI-2 SIONS REGARDING MEDICAID ELIGIBILITY EXPANSION; AND DECLARING AN EMER-3 GENCY.4

Be It Enacted by the Legislature of the State of Idaho:5

SECTION 1. That Section 56-267, Idaho Code, be, and the same is hereby6 amended to read as follows:7 56-267. MEDICAID ELIGIBILITY EXPANSION. (1) Notwithstanding any pro-8 vision of law or federal waiver to the contrary Except as provided by sub-9 section (6) of this section, the state shall amend its state plan to expand10 medicaid eligibility to include those persons under sixty-five (65) years of11 age whose modified adjusted gross income is one hundred thirty-three percent12 (133%) of the federal poverty level or below and who are not otherwise eligi-13 ble for any other coverage under the state plan, in accordance with sections14 1902(a)(10)(A)(i)(VIII) and 1902(e)(14) of the social security act.15 (2) No later than ninety (90) days after approval of this act, the16 department shall submit any necessary state plan amendments to the United17 States department of health and human services, centers for medicare and18 medicaid services to implement the provisions of this section. The depart-19 ment is required and authorized to take all actions necessary to implement20 the provisions of this section as soon as practicable.21 (3) Eligibility for medicaid as described in this section shall not be22 delayed if the centers for medicare and medicaid services fail to approve any23 waivers of the state plan for which the department applies, nor shall such24 eligibility be delayed while the department is considering or negotiating25 any waivers to the state plan. The department shall not implement any waiver26 that would result in a reduction in federal financial participation for per-27 sons identified in subsection (1) of this section below the ninety percent28 (90%) commitment described in section 1905(y) of the social security act.29 (4) If section 1905(y) of the social security act is held unlawful or30 unconstitutional by the United States supreme court, then the legislature31 shall declare this section to be null, void, and of no force and effect.32 (5) If federal financial participation for persons identified in sub-33 section (1) of this section is reduced below the ninety percent (90%) commit-34 ment described in section 1905(y) of the social security act, then the senate35 and house of representatives health and welfare committees shall, as soon36 as practicable, review the effects of such reduction and make a recommenda-37 tion to the legislature as to whether medicaid eligibility expansion should38 remain in effect. The review and recommendation described in this subsec-39 tion shall be conducted by the date of adjournment of the regular legisla-40 tive session following the date of reduction in federal financial partici-41 pation. Notwithstanding any other provision of law to the contrary, if the42

2 reduction in federal financial participation occurs outside of a state leg-1 islative session, the department shall take any action necessary to offset2 the increase in state funding, including but not limited to reductions in3 provider payment rates or elimination of optional benefits. Such actions4 shall be taken until such time as the state legislature may convene and de-5 termine a proper course of action.6 (6) No later than December 31, 2026, the department shall implement7 the community engagement requirements established pursuant to 42 U.S.C.8 1396a(xx). After the community engagement requirements have been imple-9 mented:10 (a) No person shall be enrolled in medicaid pursuant to this section un-11 less such person demonstrates compliance with the community engagement12 requirements for the three (3) consecutive months immediately preced-13 ing the month during which the person applies; and14 (b) The department shall disenroll from medicaid any person who is cur-15 rently enrolled pursuant to this section who is unable to demonstrate16 compliance with the community engagement requirements.17

SECTION 2. An emergency existing therefor, which emergency is hereby18 declared to exist, this act shall be in full force and effect on and after its19 passage and approval.20