Medicaid Enrollment Shrinks as State Reassesses Eligibility
Idaho officials now project a substantial reduction in Medicaid expenditures, estimating approximately $1.5 billion in savings over four years. The shift follows a major realignment of the state’s Medicaid program after the federally mandated pause on disenrollments during the COVID-19 public health emergency ended.
Since April 2023, Idaho has conducted a large-scale redetermination process to reassess eligibility for Medicaid beneficiaries. As of mid-2025, over 150,000 individuals have been removed from the program. This drop in enrollment represents roughly one-third of the pandemic-era peak, when total enrollment exceeded 450,000.
Revised Cost Projections Significantly Lower Than Expected
The Idaho Department of Health and Welfare now estimates that Medicaid costs will total $4.5 billion in Fiscal Year 2025, down from earlier projections that anticipated closer to $6 billion. This decline is directly tied to reduced caseloads, changes in federal matching funds, and shifts in healthcare utilization rates.
The federal government continues to provide a majority of funding for Idaho’s Medicaid program, though the state is responsible for about 30% of total costs. The revised estimates forecast an overall $1.5 billion reduction in total Medicaid spending over four fiscal years compared to previous projections.
This expected decrease has important implications for the state’s budget planning, especially as Idaho continues to maintain a strong revenue position.
Reforms Aim to Improve Efficiency and Fiscal Sustainability
The redetermination effort is part of a broader push by the state to ensure that Medicaid benefits are reserved for residents who meet eligibility requirements. The review process includes checking income thresholds, household changes, and other qualifying conditions.
In tandem with these efforts, state leaders are exploring additional long-term reforms to contain costs, reduce administrative burdens, and prioritize access for Idahoans with the greatest need. Officials note that the state will continue monitoring trends in healthcare prices and service demand to adjust projections accordingly.
The Idaho Legislature’s Joint Finance-Appropriations Committee (JFAC) is expected to factor these revised estimates into the 2026 budgeting cycle.
Related Coverage
- Idaho News – https://idahonews.co/idaho-news-3/
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