Medicaid expansion is one of the smartest investments Idaho has ever made. For every dollar our state puts in, Idaho draws down nine federal dollars. No other line item delivers a stronger return, and few do more to strengthen our economy, stabilize rural health care, and protect working families.
It’s alarming that Republicans on Idaho’s so-called DOGE task force recently recommended repealing Medicaid expansion. That vote sets the stage for one of the biggest fights of the 2026 legislative session, and Idahoans deserve a straight answer about the consequences.
Medicaid expansion works because it replaces the most expensive and least effective kind of health care: waiting until people are sicker and showing up in crisis. Before expansion, Idahoans stuck in the coverage gap still got care, but only when things became an emergency. The bills landed on counties, the state, hospitals, and local systems already stretched thin. Behavioral health care was pushed into an underfunded patchwork. Drug courts, jails, and corrections absorbed the fallout of untreated mental illness and addiction. Everyone paid, just in the worst possible way.
The savings across state and local budgets have been enormous and have consistently exceeded the state’s 10% contribution to expansion. Medicaid expansion reduced pressure on county indigent programs and state catastrophic care, and it allowed Idaho to scale back duplicative, state-funded backstops that existed only because so many people were falling through the cracks.
Repealing Medicaid expansion would undo years of progress. Hospitals would feel it immediately. Emergency rooms would fill up. Wait times would climb. Rural hospitals, already operating on thin margins, would be pushed closer to closure. And when a rural hospital closes, jobs disappear, families drive farther for care, and communities lose an anchor they can’t easily replace.
The economic stakes are massive. Medicaid expansion brings about $1.57 billion into our economy, creates 9,362 jobs, and generates $12 million in property tax revenue and $35 million in state revenue. It is reckless to yank this economic engine from our communities, especially at a time when unemployment is climbing.
Most importantly, Medicaid expansion saves lives. It means Idahoans can see a doctor, fill a prescription, and get treatment without choosing between their health and paying rent. It has been especially critical for mental health care, opening the door to treatment and stability for people who had nowhere else to turn.
Idahoans know this program works. Voters passed Medicaid expansion in 2018 with 61% support, and it is even more popular today. Polling shows 73% of Idahoans want it to stay in place.
Voters made their decision. Idaho Democrats will fight to uphold Medicaid expansion. I invite Republicans in Boise to put politics aside and stand with the people they represent.
Onward,
Lauren Necochea
Idaho Democratic Party Chair