ID H0328

Requires legislative approval before the Idaho Department of Health and Welfare can seek or implement any Medicaid state plan amendment or Section 1115/1915 waiver that would expand coverage or increase net state costs, with approved amendments listed in a new Chapter 22 of Title 56

Mandates submission of state plan amendments by July 1, 2026 for participant cost-sharing, comprehensive Medicaid managed care, and work requirements of 20 hours per week for able-bodied adults aged 19-64 enrolled in Medicaid expansion

Allows Medicaid expansion enrollees with income at or above 100% of the federal poverty level to opt for premium tax credits to purchase private insurance through the state exchange instead of Medicaid enrollment

Requires site-neutral payment policies by July 1, 2026, setting reimbursement for hospital outpatient departments and hospital-acquired physician practices at the same rate as physician-owned practices for equivalent services

Voids administrative rules in IDAPA 16.03.17 (Medicare/Medicaid Coordinated Plan Benefits) and IDAPA 16.03.18 (Medicaid Cost-Sharing) effective July 1, 2025, and certain sections of IDAPA 16.03.09 (Medicaid Basic Plan Benefits) effective January 1, 2026