Rating: +1

Bill Summary:

House Bill 199 codifies the Refugee Medical Assistance (RMA) Program into Idaho state law by creating a new Chapter 5 in Title 56, Idaho Code. The bill defines eligibility requirements for receiving federally funded refugee medical assistance, which is provided under federal law (42 U.S.C. 1396 and 1397) and subject to both federal funding and state spending authority.

Eligibility is strictly limited to specific immigration categories, including individuals granted refugee or asylum status under federal law, Cuban/Haitian entrants, Afghan and Iraqi special immigrants, and certain Amerasians. The bill sets an income cap for eligibility at 133% of the Federal Poverty Guidelines, with a “spend down” provision for those slightly above that threshold. It also explicitly excludes sponsor-provided income and shelter from eligibility calculations to align with federal standards.

Importantly, HB 199 repeals the related section of IDAPA 16.03.06, eliminating outdated or duplicative administrative rules, and places clear statutory boundaries on who may access the program. It includes an emergency clause, making the law effective July 1, 2025.

Reason for Rating:

HB 199 limits the scope of refugee medical assistance to individuals who already qualify under tightly defined federal law and ensures those services are tied to available federal funds—not state-only Medicaid expansion or entitlements. It also removes the administrative rulemaking authority that could otherwise expand benefits outside legislative oversight. The bill promotes transparency, fiscal responsibility, and state sovereignty in managing federally funded programs. For these reasons, it earns a +1 rating.