House panel advances broad Medicaid bill after hours of testimony on work requirements, managed care and provider protections

Representative Jordan Redmond, sponsor of House Bill 345 (titled the Medicaid Affordability and Health Care Access Act), told the House Health and Welfare Committee the bill combines multiple reforms aimed at stabilizing Medicaid expansion costs and preserving access to care. Redmond outlined a package that would: move Idaho from the current VCO (value contracting organization) model toward comprehensive Medicaid managed care (MCOs); permit limited cost sharing and work-reporting requirements for certain expansion enrollees; protect practice authority for certain clinicians; require site-neutral payments (with exemptions for critical access and rural emergency hospitals); and create legislative oversight via a Medicaid review panel.

Redmond said the bill removes a previously proposed 36-month lifetime limit, an enrollee cap, and a repeal trigger that had been part of earlier proposals. He described the bill as larger in scope than earlier iterations and said it includes immediate savings estimates. He also said the bill exempts Federally Qualified Health Centers (FQHCs) from downside risk under managed care and seeks a shift from Upper Payment Limit (UPL) funding to directed payments, with a 30% state-directed payment component preserved in the transition.

Committee members pressed the sponsor on implementation details. Representative Egbert and others asked whether the Department of Health and Welfare would need additional FTEs to implement waivers and biannual redeterminations; Director Alex Adams (Department of Health and Welfare) testified the department’s fiscal note…