Medicaid Reform

It’s Time to Save Medicaid — Here’s How We Do It

2025 is going to be a great year for Idaho. 

With a new innovation-minded president in the White House to partner with us, we have an incredible opportunity for bold reforms this year. The golden age of America will be a golden age for Idaho, too. 

One of the first items on our reform list should be to fix our broken Medicaid program and make it work for Idahoans. 

That starts with getting Medicaid spending under control because its present path is unsustainable. 

Idahoans are generous and we want to help those in need. But Medicaid—a program designed tohelp the disabled, aged, pregnant women and poor children—has become stretched thin through expansion to able-bodied adults. When our state first expanded Medicaid to able-bodied adults under ObamaCare, we were told that, at most, 62,000 would enroll. The reality? Double that. 

The budget realities and workforce issues from this overrun put the program at risk. We cannot properly serve the truly needy if we drive our state budget off a cliff. To take control of the steering wheel before we get to that point, I’ve introduced legislation that will address some of the biggest challenges we face with Medicaid so that we can better address local needs. 

First, we need more safeguards to prevent waste and reorient Medicaid toward the truly needy. Right now, the Medicaid budget is roughly one-third of all state spending. Worse yet, a large percentage is being spent improperly, going to ineligible people or otherwise wasted. 

We have room to be more diligent when it comes to oversight, verification processes, and auditing of enrollees and payments. Right now, you can enroll in our Medicaid program without even proving that you live here. We need more frequent eligibility checks to keep up with life changes.

Second, we need to ensure that able-bodied adults on Medicaid who can work, do work. Currently, able-bodied adults in Idaho are not required to work as a condition of enrollment in Medicaid. There is also no limit on how long they can collect benefits—an able-bodied adult can collect Medicaid in Idaho for the next 30 years if he or she wants to.

When I talk to folks in North Idaho who supported Medicaid expansion, this isn’t what they wanted for Idahoans. The vision was to help people who need some help with health care coverage while they go through a rough patch in life. It was never meant to be a gateway to permanent government dependency for those who can and should be working. 

Our labor force participation rate has dropped significantly in the past 20 years. Requiring able-bodied adults to work, train, or volunteer at least part time as a condition of enrollment has the potential to dramatically increase incomes and improve quality of life. Arkansas’s work requirements for Medicaid led to about 14,000 people leaving the program for more lucrative opportunities, freeing up resources for those who need them. If you fall on hard times, Idaho will always have your back, but you need to meet us halfway by making an investment in your future by working, volunteering, or getting an education. 

And finally, Idahoans know better than anyone how to help our communities. My legislation asks for the federal government to give our state more flexibility in Medicaid to help ensure state funding is being used wisely and in the best interests of those who call Idaho home. PresidentTrump and his administration have been clear that they want new and innovative ideas to long-standing problems. We believe this reform is exactly what he is looking for and could be a road map for other states to follow.

We all want to help our neighbors, but we don’t have infinite resources, and we cannot allow ourselves to stretch the program until it snaps.

At this unique moment in history, it’s time to enter our own golden age through bold reforms that make our state even greater.

-Rep. Redman