Effective July 1, 2026, Idaho House Bill 928, titled the Merit‑Based Health Care Act, establishes new requirements for health care providers that participate in Idaho’s Medicaid program. The law conditions participation in Medicaid on the requirement that employment, contracting, and other decision‑making paid for with Medicaid funds be based on individual merit, qualifications, and clinical competency, rather than race‑ or sex‑based considerations. While the Act does not redefine protected classes or alter existing civil rights protections, it restricts the use of Medicaid funds in connection with what the statute defines as prohibited diversity, equity, and inclusion (DEI) conduct.
Under the Act, Medicaid‑participating providers may not engage in discriminatory hiring or contracting practices, may not require participation in prohibited DEI activities, and may not use state Medicaid funds for public‑facing communications that promote prohibited DEI conduct. Compliance with the Act is expressly designated as a material condition of all Medicaid provider agreements, meaning a violation may have consequences beyond monetary penalties, including potential contractual or reimbursement implications. Importantly, the statute preserves compliance with federal civil rights laws, making clear that providers must continue to meet federal nondiscrimination requirements even as they adhere to the state’s merit‑based standards.
Enforcement authority rests primarily with the Idaho Attorney General, who may investigate alleged violations upon receipt of a formal complaint. Before imposing penalties, the Attorney General must provide written notice and an opportunity for corrective action. Civil penalties scale based on provider size: providers with 50 or more employees face penalties ranging from $10,000 for a first violation to $100,000 for third or subsequent violations, while providers with fewer than 50 employees face penalties ranging from $5,000 to $50,000 for repeated violations. In addition, health care professionals are given a private right of action for retaliation if they are penalized or terminated for refusing to participate in prohibited DEI conduct, with available remedies including reinstatement, injunctive relief, compensatory damages, and reasonable attorney’s fees. Health care entities participating in Idaho Medicaid should review hiring, contracting, training, and communications practices ahead of July 1, 2026 to ensure compliance with the new merit‑based framework.