Legislative Notebook: Governor signs bill making major changes to Idaho Medicaid

Idaho Gov. Brad Little gives a press conference after delivering his annual State of the State address on Jan. 6, 2025, in the Lincoln Auditorium in the Idaho Capitol. (Pat Sutphin for the Idaho Capital Sun)

In an effort to help Idahoans follow major bills, resolutions and memorials through the legislative process, the Idaho Capital Sun will produce a “legislative notebook” at the end of each week to gather information in one place that concerns major happenings in the Legislature and other news relating to state government. To receive the full extent of our reporting in your inbox each day, sign up for our free email newsletter, The Sunrise, on our website at idahocapitalsun.com/subscribe/.

Here is our quick rundown of the major happenings during the 11th week of the Idaho Legislature’s 2025 session.

Idaho Gov. Brad Little signed into law a bill that proposes sweeping policy changes to control Medicaid’s costs.

House Bill 345 calls for the state to seek work requirements for able-bodied Idahoans on Medicaid, and to give Idahoans eligible for Medicaid expansion access to tax credits to buy insurance on the state’s health care exchange.

In both chambers of the Idaho Legislature, the bill passed on party-line votes, with all 90 Republican state lawmakers supporting it and all 15 Democratic state lawmakers opposing it.

“We want Idahoans to become as self-sufficient as possible. House Bill 345 reinforces that goal while reasonably reeling in Medicaid spending so taxpayers are not overly burdened by this program in the outyears,” Little said in a written statement.

Opponents of the bill argue that most people in the Medicaid expansion population are already working, and that the requirements will add burdensome hurdles that will prevent Idahoans from accessing health care.

“Governor Little and every Republican legislator just ripped health coverage away from thousands of Idahoans,” Idaho Democratic Party Chairwoman Lauren Necochea said in a written statement. “Voter-enacted Medicaid expansion largely covers working Idahoans, but it’s also a lifeline for those who lose jobs, have hours cut, or need to care for a sick family member. These so-called ‘work requirements’ do nothing to help find jobs, but they will take away insulin, cancer treatment, and mental health services.”

The bill takes effect immediately through an emergency clause.

Little also signed into law a bill that prevents health care professionals and entities from being forced to participate in nonemergency procedures that would violate their sincerely held religious or moral beliefs.

Sen. Carl Bjerke, R-Coeur d’Alene, and Rep. Bruce Skaug, R-Nampa, co-sponsored House Bill 59, dubbed the Medical Ethics Defense Act.

The bill takes effect immediately, through an emergency clause. 

“Health care providers shall have the right of conscience and, pursuant to this right, shall not be required to participate in or pay for a medical procedure, treatment, or service that violates such health care provider’s conscience,” the bill states.

Planned Parenthood Alliance Advocates Idaho’s director Mistie DelliCarpini-Tolman asked Little to veto the bill, saying “it gives health care workers a license to discriminate.” 

The bill “will undermine medical standards, put patients’ lives at risk, and create legal chaos for Idaho’s entire health care system,” DelliCarpini-Tolman said in a written statement. “No one should be denied care because of someone else’s personal beliefs. Health care must be driven by medical expertise, not ideology.”

• House Bill 243: Co-sponsored by Reps. Barbara Ehardt, R-Idaho Falls, and Rod Furniss, R-Rigby, the bill would repeal Idaho law that allows city and local governments to set more rigorous child care oversight than the state. The bill was amended by the Senate to relax requirements on child-to-staff ratios. The amendments were passed by the House on Wednesday. It now heads to the governor for final consideration.
• Senate Bill 1101: Sponsored by Sen. Melissa Wintrow, D-Boise, the bill clarifies and adds guidance to Idaho coroners’ roles in death investigations. The governor signed the bill into law on Wednesday.
• House Bill 83: Sponsored by Senate Pro Tem Kelly Anthon, R-Burley, the bill would allow local law enforcement to work with federal authorities to regulate the presence of unauthorized immigrants in Idaho. The bill would also allow law enforcement to record a person’s documentation status only if they are already detained or under investigation for a crime. If an individual involved in a crime is found to be living in Idaho without legal authorization, they would face a misdemeanor charge for “illegal entry,” a new crime under the bill. A second offense would result in a felony charge, and a conviction would lead to deportation, under the bill. The House passed the bill 61-9 on Wednesday.  It now heads to the governor for final consideration.
• House Bill 290: Sponsored by Rep. Dori Healey, R-Boise, the bill would transfer decision-making authority about vaccination requirements for children attending day cares and schools from the Department of Health and Welfare to the Idaho Legislature. The Senate voted 23-11 on Wednesday to pass the bill.  It now heads to the governor for final consideration.
• House Bill 41: Sponsored by Rep. Ted Hill, R-Eagle, and Sen. Tammy Nichols, R-Middleton, the bill would prohibit flags in public schools “that represent a political viewpoint, including but not limited to flags or banners regarding a political party, race, sexual orientation, gender, or a political ideology.” The governor signed the bill into law on Wednesday.
• House Bill 380: Sponsored by Rep. Bruce Skaug, R-Nampa, the bill would allow prosecutors to seek the death penalty for a new criminal charge the bill creates: aggravated lewd conduct with children age 12 and younger. The House voted 63-0 on Monday to pass the bill. The Senate Judiciary and Rules Committee advanced the bill with a do pass recommendation, and it is now on the Senate’s third reading calendar. It may be considered in the coming days of the session.
• Senate Bill 1046aa: Sponsored by Sen. Tammy Nichols, R-Middleton, and Rep. Heather Scott, R-Blanchard, the bill requires Idaho public schools to provide human growth and fetal development instruction via ultrasound video and computer-generated renderings for students in grades 5 through 12. The House voted 63-6 to pass the bill on Tuesday. It now heads to the governor for final consideration.
• House Bill 158: Sponsored by Reps. Barbara Ehardt and Marco Erikson, both R-Idaho Falls, the bill would create a media shield law protecting sources who provide confidential information or documents to journalists. The Senate voted 35-0 to pass the bill. It now heads to the governor for final consideration.

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Senate State Affairs Committee

House Bill 339: Sponsored by Reps. Brandon Mitchell, R-Moscow, and Brent Crane, R-Nampa, as well as Secretary of State Phil McGrane, the bill requires the secretary of state to request information from various government agencies, such as the Idaho Department of Health and Welfare and the Idaho Transportation Department, to help maintain accurate and up-to-date voter rolls. It is scheduled for a full public hearing before the committee on Monday.

House Bill 148: Sponsored by Reps. Chris Bruce, R-Kuna, and Todd Lakey, R-Nampa, the bill outlines the process for Idaho residents involved in legal proceedings with the federal government concerning grazing or water rights to request state assistance from the state’s constitutional defense fund. The bill specifies the criteria and procedures for the Constitutional Defense Council to consider such requests and provides details on the type of assistance offered. It is scheduled for a full public hearing before the committee on Monday.

Senate Education Committee

Senate Bill 1142: Sponsored by Sen. Lori Den Hartog, R-Meridian, the bill would repeal the state’s Empowering Parents Grant Program. It is scheduled for a full public hearing before the committee on Monday.

“We heard from libraries across the state – Moscow, Troy, Hailey, Potlatch, Elmore County, Genesee and beyond. They asked us – implored us – that we would reconsider based on the programs they intend to offer. We heard about computer classes ready to be offered to seniors teaching about cybersecurity and helping folks understand the danger of clicking on links from emails that maybe they don’t know who the sender is. Telehealth for the rural communities. Computer access for veterans who want to access their VA services.” – Rep. Soñia Galaviz, a Boise Democrat, who made an unsuccessful motion to pass the Idaho Commission for Libraries budget with approval for a full $2.5 million federal grant, but she was overruled by the Republican supermajority, which allocated $1.23 million instead

House Majority Leader Jason Monks acknowledged the work still remaining before the budget committee on lawmakers’ target adjournment date. #idleg #idpol pic.twitter.com/J1Nzsuq7uB

— Idaho Reports (@IdahoReports) March 21, 2025

Reporting from Idaho Capital Sun journalists Clark Corbin, Mia Maldonado and Kyle Pfannenstiel contributed to this legislative notebook.