Amends existing law to require certain federal waivers for continued medicaid expansion eligibility.

This legislation safeguards Idaho’s Medicaid program by ensuring its sustainability, prioritizing resources for needy populations and promoting fairness and accountability. It establishes conditions for the continued expansion of Medicaid eligibility for able-bodied adults, aligning the program with the principles of self-sufficiency, fiscal responsibility, and integrity. Key provisions include: 1) Work Requirements: Able-bodied adults must work, train, or volunteer at least 20 hours per week, mirroring existing requirements for other welfare programs in Idaho. 2) Enrollment Caps: The number of able-bodied adult enrollees will not exceed the population of seniors or individuals with disabilities, ensuring resources prioritize the most vulnerable. 3) Improper Payment Controls: The Department of Health and Welfare must reduce improper Medicaid payment rates to 5% or less. 4) Verification of Eligibility: Enrollee eligibility will be reviewed biannually. 5) Time-Limited Benefits: Able-bodied adults will be subject to a three-year lifetime limit on Medicaid benefits. 6) Optional Private Coverage: Enrollees above 100% of the federal poverty level may opt for federally subsidized private health insurance. This conditional approach strengthens Idaho’s Medicaid program while maintaining flexibility. If the federal government or state agencies fail to meet these requirements, the legislation ensures Medicaid dollars are redirected to serve the truly needy.