Idaho Medicaid to be privately managed in 2029, health officials expect
Idaho health officials say it’ll take years to switch all Idaho Medicaid benefits to being managed by private companies.
Through a sweeping bill meant to cut Medicaid costs, the Idaho Legislature this year directed the Idaho Department of Health and Welfare to change a range of Medicaid policies — including to pursue switching Medicaid benefits to being run by private companies.
That model, called managed care, is used widely across the country.
Right now, Idaho Medicaid already uses managed care — somewhat. But it’s more of a patchwork approach, where some services are managed by the state health department, some by managed care organizations, and some by doctors’ offices.
Shifting Idaho Medicaid to managed care will take time to do well, Idaho Medicaid Deputy Director Juliet Charron told a panel of state lawmakers late last month.
The Idaho Department of Health and Welfare expects the new comprehensive Idaho Medicaid managed care contract to start in 2029, following years of prep work, she told the Idaho Legislature’s Medicaid Review Panel on May 22.
“We have been evaluating all of the different scenarios and timelines under which we could implement this — looking at it as early as 2027 or 2028 — and have determined” that going much earlier is risky, Charron said. “Because you’re going to start to have pieces overlapping throughout this. And that will be particularly challenging for our provider communities.”
Medicaid is a largely federally funded health care assistance program that covers about 260,000 Idahoans, including low-income earners, people with disabilities, pregnant women, and some older people. Roughly 92,000 Idahoans are enrolled in Medicaid expansion, a voter-approved policy that raised the income eligibility cap.
The new Idaho Medicaid cost cutting bill also called for Idaho to seek federal approval for Medicaid work requirements for able-bodied adults. The Idaho Department of Health and Welfare plans to apply for that by July 2026.
The federal spending and tax cut bill being considered by Congress might ease the process for Idaho to seek Medicaid work requirements.
Instead of applying for a Medicaid waiver that could temporarily allow for work requirements, Idaho could seek a longer-lasting state plan amendment for Medicaid work requirements — if the federal bill becomes law, Charron said. (The bill would require nationwide Medicaid work requirements years later. After passing the U.S. House, it heads to the Senate, where changes are expected.)
Other states’ experiences and a federal watchdog report suggest costs for Medicaid work requirements are high, the Idaho Capital Sun previously reported.
Since almost half of Idahoans on Medicaid are already working, some advocates say work requirements are effectively just expensive administrative barriers to access the program.