Gender Affirming Care for Minors

Last week, we highlighted the introduction of HB 71 by Rep. Bruce Skaug (R-Nampa), which would criminalize gender affirming care (GAC) for transgender minors by making it a felony to provide surgery, hormone therapy or puberty blockers.

On February 7, just one week later, HB 71 received a hearing in the House Judiciary Committee. For nearly two hours, the committee heard testimony on both sides from around the state. Several IMA members participated in opposition to the bill, while others like Dr. Marvin Alviso were not given an opportunity to testify.

Dr. Neil Ragan discussed the number patients he has treated over the years, including the years-long journey it takes for successful treatment. Most importantly, he provided insight into the lives he has saved – children on the verge of suicide.

Dr. Brandon Mickelson shared a personal story explaining the struggle of treating a patient in pain and the importance of empathy. He asked the Legislature not to take away necessary tools in caring for transgender kids.

Dr. Megan Schwehr, a lifelong Idahoan, explained the impact of criminalizing our physician workforce, and her recent desire to leave the state so she can treat patients without second guessing herself.

The committee heard firsthand stories from multiple parents sharing the anguish of watching their children struggle with severe mental health issues – including suicidality – prior to treatment.

Just as in 2022, the legislation passed along party lines with a 14-3 vote. HB 71 was sent to the full House with a do pass recommendation, and it is expected to easily pass the House on a floor vote. The IMA Lobby Team will continue working with our physician members to oppose HB 71 and combat misinformation around GAC.

(Another) Medicaid Update

Recently, Juliet Charron, Idaho Division of Medicaid administrator, discussed a cost containment analysis that is being performed by a third-party consultant. On February 6, the House and Senate Health and Welfare Committees received the short-term report and recommendations to save money in the Medicaid program.



Tasked with a goal of finding $45 million in recommended savings, the consultant presented a plan with approximately $65 million in savings. Among the recommendations is a 7.5% across the board cut in provider reimbursements, totaling $21 million for professional services – including physician payments – and $16.8 million in combined cuts for hospitals.



Members of the House Health and Welfare Committee pushed back on a number of the recommendations, questioning the consultant in regard to the unintended consequences of such drastic cuts which will almost certainly impact access to services for Medicaid patients. The consultant admitted this is a likely outcome but, when pressed, couldn’t predict what specific impacts the cuts would have on physician and other providers being able to accept Medicaid. Committee members also expressed concerns with the long-term Medicaid budget when making short-term, almost reactionary, cuts.

The final cost containment report from the consultant will focus solely on those long-term recommendations and will be presented in the first week of April.

Federal Update

On Thursday, Senator Mike Crapo introduced bipartisan, bicameral legislation to assess preventive health care. The legislation would instruct the Congressional Budget Office to extend its current 10-year analysis to more accurately reflect the long-term cost savings for preventive health care initiatives.



In a press release, Senator Crapo said, “Preventative health care lowers costs and ensures Americans can live longer, healthier lives. This bipartisan legislation is a much-needed reform that will allow lawmakers to capture long-term savings achievable through preventative care, giving Congress a more comprehensive picture when enacting legislation to improve our overall health care system.”

You can read Senator Crapo’s press release and learn more about the legislation by following the link: