Medicaid in Trouble? These 3 States May Cut Health Coverage for Thousands

Medicaid expansion, a program that has helped millions of Americans gain access to affordable health care, is now at risk in three states, Idaho, Montana, and South Dakota. Lawmakers in these states are considering major cutbacks due to growing budget concerns, potentially leaving thousands without health coverage.

Idaho: Repeal on the Table

Idaho’s legislature is taking serious steps toward repealing Medicaid expansion altogether. With costs climbing, some lawmakers argue the program has become too expensive for the state to sustain. Proposals include drastic measures like limiting how long someone can stay enrolled in Medicaid, which would be a first in the nation.

Critics of the move say it’s short-sighted. Health experts argue that Medicaid expansion has actually saved the state money by reducing the number of uninsured patients who require expensive emergency care. If repealed, an estimated 145,000 Idahoans could lose their coverage.

Montana: Financial Pressure Mounts

Montana, another state that adopted Medicaid expansion, is also feeling the financial squeeze. State officials are worried about the rising share of costs they must cover, especially with the possibility of reduced federal funding on the horizon.

Without continued federal support, Montana would need to find other ways to fill the funding gap—or scale back the program. Lawmakers are debating whether the state can afford to keep it going without new revenue sources or major spending cuts elsewhere in the budget.

South Dakota: Reversal Movement Grows

In South Dakota, just a year after voters approved Medicaid expansion, some lawmakers are pushing to undo it. They argue the costs are too high and that the state should rethink its commitment before the financial burden gets worse.

However, many healthcare providers warn that rolling back the program could have serious consequences, especially in rural communities where Medicaid is often the only reliable form of health coverage for low-income residents.

National Picture: A Domino Effect?

What’s happening in these three states could signal a larger trend. Across the country, states are facing tough budget choices, and Medicaid is a major line item. A recent study found that if federal support for Medicaid expansion is reduced, states could be forced to cover an extra $44 billion in costs. That’s a big ask—even for states with solid budgets.

Health policy experts are sounding the alarm. If Medicaid expansion starts unraveling, it could leave millions of Americans vulnerable, especially in states that already have limited access to affordable healthcare.

What’s Next?

The coming months will be crucial. Legislators in Idaho, Montana, and South Dakota are expected to make key decisions on Medicaid funding soon. For now, the future of expansion remains uncertain—and thousands of families are left wondering what will happen to their healthcare.

If you live in one of these states, now might be a good time to contact your representatives and stay informed. The decisions being made today could have a lasting impact on healthcare access for years to come.