**Category:** Idaho Politics and Government
**Tags:** Healthcare, Medicaid, Work Requirements, Idaho Legislature, Brad Little, One Big Beautiful Bill
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# Idaho Legislature Passes Bill Implementing Medicaid Expansion Work Requirements by 2027
## WHY IT MATTERS
Idaho Medicaid expansion enrollees could face significant changes to their coverage under legislation that cleared the Idaho Legislature this week. Researchers estimate the new work requirements could remove tens of thousands of Idahoans from the program — a shift that would reshape how the state delivers healthcare to its lower-income working-age population.
The bill now heads to Gov. Brad Little, whose signature would set the state on a course to implement one of the most consequential changes to Idaho’s Medicaid program since voters approved expansion in 2018.
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## WHAT HAPPENED
The Idaho Legislature passed House Bill 913, which directs the state to adopt Medicaid work requirements for adults enrolled in Medicaid expansion by the end of 2027. The requirements align Idaho policy with provisions included in President Donald Trump’s signature legislative package, the One Big Beautiful Bill Act.
The Idaho Senate approved the measure on a 28-6 party-line vote Tuesday, March 31, 2026, following earlier passage in the House. The bill now awaits action from Gov. Brad Little.
Under the legislation, able-bodied Medicaid expansion enrollees would be required to demonstrate participation in work, job training, education, or community service in order to maintain their coverage. Supporters of the bill argue the policy ensures that Medicaid resources are directed toward those who truly need them while encouraging workforce participation among recipients who are capable of employment.
Opponents, including disability advocates and Medicaid access groups, argue the requirements function primarily as administrative burdens rather than genuine workforce incentives. Critics contend that many currently working Idahoans could lose coverage not because they fail to meet the work threshold, but because they fail to navigate complex reporting paperwork on time.
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## BY THE NUMBERS
– **28-6** — The Idaho Senate margin on the party-line vote approving House Bill 913
– **Up to 44%** — The estimated share of Idaho Medicaid expansion enrollees who could be removed from the program under the new requirements
– **20,000 to 34,000** — The estimated number of Idahoans projected to lose Medicaid expansion coverage by 2028, according to researchers
– **2027** — The deadline by which Idaho would be required to implement the work requirement rules under the bill
– **2018** — The year Idaho voters approved Medicaid expansion through a citizen initiative, adding the expansion population that would now be subject to these requirements
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## ZOOM OUT
Idaho’s move mirrors a broader national trend among Republican-led states seeking to align their Medicaid programs with the framework established in the One Big Beautiful Bill Act. The federal law provides a framework for states to impose work requirements on expansion enrollees — a policy that the Trump administration has promoted as a tool to reduce federal Medicaid spending and incentivize self-sufficiency.
Several states across the Mountain West and the broader country are weighing similar changes as the federal government shifts more responsibility and cost-sharing expectations onto states. In states where Medicaid expansion was approved by voters rather than the legislature — as was the case in Idaho — these restrictions add a layer of political complexity, since the original expansion was driven by direct democratic action rather than legislative consensus.
Analysts note that work requirement policies have faced legal challenges in other states in previous years, though the current federal statutory authorization through the One Big Beautiful Bill Act provides stronger legal footing than previous executive-level efforts.
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## WHAT’S NEXT
The bill now sits with Gov. Brad Little, who has not publicly signaled whether he will sign or veto the measure. Little has previously expressed interest in ensuring Medicaid remains fiscally sustainable while maintaining support for Idahoans with genuine needs.
If signed, state agencies will need to develop and submit implementation plans to align Idaho’s Medicaid program with federal work requirement standards before the 2027 deadline. That process will likely involve federal approval of a state plan amendment and a public comment period.
Advocacy groups opposed to the legislation are expected to continue pressing the governor’s office and may explore legal avenues if the bill becomes law. Idahoans currently enrolled in Medicaid expansion should expect potential notification and reporting requirements in the coming years if implementation moves forward on schedule.
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