The U.S. is facing a maternal mortality crisis, and the situation in Idaho is especially dire. The state has the lowest physician supply in the country and ranks in the bottom 10% for maternal health outcomes.
One proven way to save lives? Guarantee health care coverage after pregnancy. Research has shown that extending Medicaid coverage for 12 months postpartum improves health outcomes for both parents and infants.
In 2024, the Idaho Legislature passed House Bill 633 to adopt this kind of policy. But when the Idaho Department of Health and Welfare submitted its implementation plan, it added an unlawful twist: the extended coverage wouldn’t apply to people who had abortions.
Thankfully, the Centers for Medicare & Medicaid Services (CMS) rejected that plan in March 2025. But Idaho is now appealing the decision — and we’re working to ensure it never goes through.
Together with the National Health Law Program, we submitted an amicus brief outlining the plan’s major problems:
- It violates the federal Medicaid Act.
- It wasn’t shared properly with Indian Health Programs and Urban Indian Organizations.
- It conflicts with Idaho law, which requires legislative approval for this kind of change.
- It would make the state’s maternal health crisis even worse.
The fourth point is especially important. To enforce this exclusion, Idaho would need to track how each Medicaid-covered pregnancy ends: miscarriage, stillbirth, or abortion. That kind of surveillance could scare people away from seeking care, even those fully eligible for coverage. As a result, more people would go without critical postpartum health care, and we would see worse outcomes across the state.
To get the full breakdown of Idaho’s plan, read our amicus brief below.
