You know that feeling at the end of a Jenga game—each move uncertain, each piece pulled threatening to destabilize the entire structure, leaving it on the brink of collapse. You hold your breath, hoping the tower holds, knowing that one wrong move could send everything tumbling. That’s where Idaho’s healthcare system stands today, and I fear House Bill 138 (HB138) could be the move that brings it all down.

The implications of HB138 are far-reaching. This bill involves significant changes to Medicaid expansion, including conditions that must be met for these changes to take effect. Specifically, it requires the approval of 11 federal waivers, and without them, Medicaid expansion will be repealed by July 2026. This timeline presents an almost impossible challenge, and if not met, tens of thousands of Idahoans will lose healthcare coverage, throwing our healthcare system into uncertainty.

Health West is honored to provide quality healthcare in 12 clinics across Idaho, more than half of which are in rural communities. Medicaid expansion has enabled more than 5,000 patients — many of whom are small business employees, farmers, and working families — to access primary and preventive care, reducing reliance on costly emergency room visits. The services we provide are built on decades of trust with the communities we serve. HB138 threatens to dismantle this progress almost overnight. It would not only leave Idahoans without coverage but also strain local healthcare providers, including Health West, who rely on Medicaid to maintain services.

The bill’s potential impact is profound. Providers across Idaho, especially in rural areas, will face impossible decisions about which services to cut, potentially leading to the closure of health centers. In places like Lava Hot Springs, where Health West is the only provider, changes to healthcare services would leave these communities with limited or no access to care. This bill would also jeopardize critical training programs that develop the next generation of healthcare professionals. The loss of these programs would hinder our ability to meet the healthcare needs of future generations. A reduction in dental and behavioral health services would push more patients into already overcrowded emergency rooms, placing additional strain on a system that is already stretched thin. A decrease in services could have a devastating long-term effect on healthcare infrastructure. After years of work to recruit and retain healthcare professionals, cuts to programs and services could worsen the ongoing shortage of providers, undoing much of the progress Idaho has made to strengthen its healthcare system.

What is especially concerning is that many Idahoans will be forced to make impossible decisions between their health and basic necessities. For instance, a college student with a chronic condition may have to drop out and work multiple jobs just to afford healthcare coverage. Cancer patients who can no longer work might be left without the critical care they need. Families may have to forgo essential healthcare due to financial constraints.

With no other recourse, individuals may be driven to seek care in emergency rooms, where hospitals, already overwhelmed, may struggle to provide necessary services. This could result in Idaho becoming a state where emergency services are inaccessible, and rural hospitals and critical care centers close their doors. These are not abstract concerns; they are very real, painful decisions that thousands of Idahoans will face if HB138 passes.

While Medicaid should always be assessed for efficiency and sustainability, HB138 fails to offer viable solutions. Rather than improving Medicaid, it strips coverage from thousands of Idahoans without offering an alternative. Medicaid expansion has proven financially beneficial for Idaho. This funding strengthens local economies, supports healthcare jobs, generates tax revenue, and reduces the financial burden on hospitals by decreasing uncompensated care. Every dollar invested in Medicaid expansion generates significant returns through improved health outcomes, greater workforce participation, and reduced reliance on emergency services. Repealing Medicaid expansion isn’t just a poor policy choice; it undermines Idaho’s economic future.

A wise mentor once described leadership as the ability to guide individuals from point A to point B with clarity. We need clarity from our representatives supporting this bill to understand how to navigate this impossible next turn. HB138 is a devastating move for Idaho, and its potential consequences are too great to ignore. The future of our healthcare system, local providers, and the well-being of tens of thousands of Idahoans are on the line. We urge those supporting this bill to reconsider the long-term damage it could cause to our state. Please contact your representatives and express your concerns about House Bill 138. Together, we can advocate for a healthcare solution that works for Idaho’s future.