For years, Idaho state lawmakers have worried the federal government might cut Medicaid funds. That’s partly why the Legislature didn’t expand Medicaid to more low-income earners. In 2018, voters approved that policy through a ballot initiative.

"The One Big Beautiful Bill obviously covers a lot of different legislation, and within it, there was a section that recategorized who is eligible based on immigrant status for a handful of programs, and that was specifically Medicare, Medicaid, CHIP (Children's Health Insurance Program), SNAP, and marketplace subsidies," Thomas said.

Some of the changes to the program under the One Beautiful Bill Act include imposing stricter eligibility requirements — the most significant being 80-hour monthly work requirements for many adults on Medicaid.