Friday, April 12, 2024

2nd Regular Session of the 67th Idaho Legislature Adjourned on April 10.

The 2^nd Regular Session of the 67^th Idaho Legislature concluded on April 10 as both the House and the Senate adjourned sine die. Many have referred to this session the most frustrating in recent memory. While there were many frustrations, IMA ultimately had a very successful session, accomplishing a large number of priorities.

During our first legislative update, January 12, 2024, we highlighted IMA’s top priorities entering the session: Passing a health exception to Idaho’s abortion laws, reinstating the Maternal Mortality Review Committee (MMRC), extending Medicaid postpartum coverage to 12 months, expanding graduate medical education (GME), and resuming naloxone distribution.

While we were unable to obtain the health exception (you can read about that in detail HERE), the lobby team was successful in accomplishing the remaining priorities and even more.

Review of IMA Legislative Accomplishments and Victories

Reinstatement of the Maternal Mortality Review Committee (MMRC)

Last year, Idaho became the only state in the nation without an MMRC. Introduced by Rep. Megan Blanksma (R-Hammett) and signed into law on March 25, HB 399 will once again activate the MMRC.

HB 399 will introduce a few changes to the MMRC, most noticeably relocating the agency administering the program from the Department of Health and Welfare to the Board of Medicine (BOM). However, IMA has been assured that the BOM will do whatever it can to fulfill the intent of the legislation. The most important step is restoring the committee.

Any limitations of the law encountered by the BOM can be corrected during the next legislative session.

12-Month Extension of Medicaid Postpartum Coverage

On March 25, Governor Little signed HB 633 into law. Introduced by Rep. Megan Blanksma (R-Hammett), HB 633 extends Medicaid postpartum coverage from 60 days to 12 months. Postpartum extension removes barriers for new mothers and has been found to improve maternal mortality in other states. IMA has been working on this priority with several stakeholders for a number of years.

Where most legislation takes effect July 1 of the year it is signed, HB 633 had an emergency clause allowing it to go into effect the date it was signed – March 25, 2024.

Expanding Graduate Medical Education (GME)

On March 18, Governor Little signed HB 681 into law. This annual IMA priority is the funding mechanism to fulfill year seven of the ten-year GME expansion plan. HB 681 is a significant win as it fully funds eight new residency positions at $60,000/seat instead of the original proposal of $55,000/seat. With six additional new residents fully federally funded, there will be a total of 14 new positions in FY 2025.

Resuming Naloxone Distribution

During the budgeting process in 2023, the Department of Health and Welfare (DHW) was prohibited from distributing naloxone, stopping a program that had saved countless lives. Fortunately, HB 527, a bill largely created to move Board of Pharmacy rules to statute, also created a pathway for the State of Idaho to resume the distribution of naloxone. Effective July 1, 2024, HB 527 will allow DHW to restart this critical program as it was originally intended.

Additional IMA Priorities Become Law and Others are Defended

Six Month Prescription Contraception

For more than a decade, there have been attempts to require insurance companies to cover up to six months of coverage for prescription contraception.

Introduced by Sen. Melissa Wintrow (D-Boise) and Rep. Jack Nelsen (R-Jerome), and signed into law on March 18, SB 1234 extends coverage from three months to a maximum of six months.



IMA supports increasing access to contraception and advocated for SB 1234. We are pleased to finally see this legislation become law.

24-Hour Neurocognitive Crisis Response Holds Signed by Governor

Introduced by Sen. Melissa Wintrow (D-Boise) and signed into law on April 2, SB 1247 creates a new 24-hour crisis response hold for patients experiencing a neurocognitive disorder and are in danger of harming themselves or others. SB 1247 allows law enforcement or medical professionals to place them in this temporary status.

SB 1247 would not have become law without heavy involvement from four IMA members - Dr. Jessica Kroll, Dr. Nicole Fox, Dr. Kara Kuntz, and Dr. Abhilash Desai - who helped negotiate nearly every aspect of the legislation. 

Medicaid Expansion Repeal Bill Doesn’t Advance

In the early days of the legislative session, HB 419 was introduced and would have created 11 different “triggers” – conditions that, if unfulfilled, would repeal Medicaid Expansion. These conditions included work requirements for participants, an enrollment cap of 50,000 people, lifetime benefit limits, and a prohibition of coverage for gender-affirming care. By failing to meet any of these conditions, regardless of the reason, Medicaid Expansion would be repealed, and all participants would be disenrolled.

It is important to note that most of the conditions proposed in HB 419 have been attempted in other states but have never been approved because they violate waiver rules.

IMA provided written testimony strongly in opposition, articulating that reducing coverage for this population will not have the intended result legislators are seeking. Ultimately, HB 419 was held in the House Health and Welfare Committee.

Legislation Supporting International Physicians is Signed into Law

IMA partnered with Rep. Josh Wheeler (R-Ammon) and several stakeholders to create a pathway to licensure for internationally trained physicians.

Signed into law on March 28, HB 542 grants a three-year provisional license to qualifying applicants allowing them to practice under the direct supervision of an Idaho-licensed physician. Following the three-year apprenticeship, individuals will be eligible to apply for full licensure from the Idaho Board of Medicine.

Transparency for Pharmacy Benefit Managers (PBMs)

On March 26, Governor Little signed an extensive PBM reform bill into law.

Introduced by Rep. Jordan Redman (R-Coeur d'Alene) and Sen. Kevin Cook (R-Idaho Falls), HB 596 helps increase oversight and accountability for PBMs by requiring mandatory reporting to the Department of Insurance. The legislation also creates new definitions (that are often redefined by PBMs), requires drug rebates to be passed on to plans, pharmacies and consumers, and requires contracts with pharmacies to be transparent and fair.

IMA supported HB 596 and we believe these changes will result in lower pharmaceutical costs and greater access to necessary medications for patients.

Additional Funding for Rural Physician Incentive Program (RPIP)

RPIP provides loan repayment for physicians serving in designated Health Professional Shortage Areas in Idaho. With a focus on primary care, family medicine, internal medicine, and pediatric specialties, physicians are eligible to receive up to $100,000 in loan repayment over four years.

IMA has been a longtime supporter and advocate for RPIP funding. With the support of Governor Little, SB 1455 was signed into law on April 8 providing an additional $500,000 in one-time funding for the program.

Fentanyl Testing Strip Legislation Advances

Idaho, like most states, considers certain equipment used to test for drug purity as drug paraphernalia. This makes it illegal to use this equipment to test for fentanyl. With the rise in fentanyl-related deaths, there has been a national movement to make an exception for fentanyl testing strips. This harm reduction strategy has paid off, saving countless numbers of lives.

Rep. Marco Erickson (R-Idaho Falls) and Rep. Ilana Rubel (D-Boise) led the effort to legalize fentanyl test strips in Idaho by introducing HB 441. HB 441 received near unanimous support, receiving only two no votes, and was signed into law on March 18.

Assistant Physician Legislation Held in Committee

Rep. Jordan Redman (R-Coeur d’ Alene) introduced HB 418, legislation that would have created Assistant Physicians, creating a three-year limited license and circumventing the residency process entirely. Following the three-year apprenticeship and passing the 3rd step of the United States Medical Licensing Examination (USMLE), the Assistant Physician would be eligible to become licensed as a general practitioner.

IMA is strongly opposed to this concept. Fortunately, Rep. Redman was receptive to IMA concerns expressed by the lobby team and agreed to not advance the legislation. The lobby team expects this proposal to surface again and will continue our opposition.

Sunset Extension for Idaho Immunization Assessment Board

HB 439 was introduced to extend the sunset date of the Idaho Immunization Assessment Board to July 1, 2029. This Board is critical and tasked to assess fees from all health insurance carriers to fund the Immunization Assessment Program. Without the program, physicians and pharmacists would be required to have two sets of vaccines – one for the Medicaid population and one for everyone else. This would require dual storage units, likely impacting smaller, rural clinics, ultimately impacting access to vaccines.

IMA worked with a large group of stakeholders to ensure HB 439 was successful and on March 18 it was signed into law.

Immunization Reminder Information System (IRIS)

Early in the legislative session, legislation to change IRIS was introduced. HB 397, would have changed Idaho from an opt-out state to an opt-in, significantly impacting the way immunization data is obtained and utilized by physicians and public health agencies throughout Idaho.

IMA has a long-standing policy adopted by the House of Delegates supporting both IRIS and the opt-out standard and was strongly opposed to HB 397. After passing the full House, this legislation did not receive a hearing in the Senate Health and Welfare Committee.

Medical Staff Appointments and Reappointments Move to Three Years

In November of 2022, The Joint Commission (TJC) revised its recommendation for medical staff appointments and reappointments from two years to three years. Many of the states surrounding Idaho quickly made the change, creating a regulatory disadvantage for the state.

IMA members introduced a resolution for the 2023 House of Delegates in support of this change. With the help of the Idaho Hospital Association, this rule change was included in the IDAPA docket, adopted in the House and Senate and included in HCR 39.

Some Legislation IMA Opposed did Become Law

Needle Exchange Program Repealed

In 2019, the Idaho Legislature passed the Syringe and Needle Exchange Act which allowed individuals the ability to exchange used needles for clean ones. Syringe Services Programs (SSPs) that provide exchanges were also required to provide information on bloodborne diseases, testing for these diseases, SUD treatment, and opioid antagonists like Narcan.

Following media reports of one facility not following protocol, HB 617 was introduced, repealing the Syringe and Needle Exchange Act. IMA’s Public Health Committee was very active during the process, trying to inform legislators about the benefits and effectiveness of the program. However, HB 617 moved quickly through both chambers and was signed into law on March 25.

The lobby team will work with supportive legislators and relevant stakeholders to try to restore the program or implement something similar.

Legislation Prohibiting Public Funds for Gender-Affirming Care Signed into Law

Introduced by Rep. Julianne Young (R-Blackfoot) and Rep. Bruce Skaug (R-Nampa), HB 668 was signed into law on March 28, prohibiting public funds from being used for gender-affirming care. This includes all individuals, regardless of age, enrolled in Medicaid or state employees and their families enrolled in the state’s insurance plan.



HB 668 will set up another costly legal battle for the State of Idaho as the law will certainly be challenged in court. Similar legislation has been challenged in other states and has never become law, as it has been found to violate the 14th Amendment of the U.S. Constitution guaranteeing equal protection. This violation was described in detail during a Senate State Affairs hearing.

With a delayed effective date of July 1, 2024, along with the legal precedence established in other states, IMA remains hopeful that HB 668 will never be implemented. We will continue to provide you with updates as they become available.

Changes to Parental Rights in Medical Decision Making

Introduced by Sen. Kelly Anthon (R-Burley) and Rep. Barbara Ehardt (R-Idaho Falls), SB 1329 was signed into law on March 21. SB 1329 prohibits healthcare providers from treating a minor without parental consent and from denying a parent access to their child’s health information. The broad language could unintentionally jeopardize access to services for minors, putting their physical and mental health at risk. For example:

• Restrict a provider’s ability to provide medical services or behavioral health counseling in a situation where the child is in an abusive or neglectful home.
• Limit an adolescent’s access to STI testing, thus increasing the long-term risks to the adolescent’s health and increasing the rates of sexually transmitted infections in the community.
• Creates confusion among providers about whether they can offer behavioral health screenings or counseling for minors in urgent situations where it is not clear that their life is in imminent danger, leading to delays in care.

IMA opposed this legislation and worked with the Public Health Committee to provide information on the unintended consequences. Unfortunately, there was no path to slow down SB 1329.

IMA is working with Holland and Hart to host an educational webinar regarding the impacts of this legislation for providers. The webinar is scheduled for April 23 at 12:00 pm Mountain and you can register by clicking HERE.

IMA and the lobby team thank you for joining us on this three-month journey. We look forward to working with you all during the interim and providing you with more updates next session. 

Throughout the Legislative Session, IMA monitors legislation and provides status updates every Friday. Click here to view the IMA Bill Tracker.