From DHW Director Dave Jeppesen: Helping implement Medicaid Expansion was one of my first and biggest challenges at DHW

December 15, 2023
DHW Director Dave Jeppesen

The Department of Health and Welfare (DHW) tackles numerous challenges in its day-to-day service of Idahoans, and one of the biggest the department undertook during my tenure was mandated by Idaho voters.

In 2018, just a few months before I was appointed director, Idahoans went to the polls and enacted Medicaid Expansion, which expands Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level, which was $20,120 for an individual in 2023. 

In short, voters asked for more Idahoans to be eligible for health insurance through Medicaid. As the state agency that determines Medicaid eligibility and administers the program, DHW made that happen effectively and affordably. 

Enrollment began in November 2019, and coverage for those newly enrolled began in January 2020.

As of December 2023, around 94,587 Idaho residents were enrolled in Medicaid Expansion. These are individuals who have a monthly income of $1,563 or less, or a family of four with a monthly income of $3,192 or less.

Most of them, over 79%, have reportable income.

Some of them, 24% as of last winter, have a primary diagnosis of Serious Mental Illness. Medicaid Expansion allowed them access to a wider range of behavioral health services so they could get more comprehensive treatment. 

The cost of Medicaid Expansion is split with 90% paid for by the federal government and 10% paid for by the state. By comparison, for every dollar spent for traditional Medicaid, the federal government pays for about 70 cents, while the state pays for around 30 cents.

On average, people with a Serious Mental Illness live about 20 years less than others. Medicaid Expansion allows for more comprehensive treatment of both physical and behavioral health issues, which might help people live longer.

Containing costs is integral to making it work

Healthcare costs seem to increase each year, and containing Medicaid costs has been integral to implementing expansion.

The Healthy Connection Value Care Program focuses on paying healthcare providers for value, rather than volume. Medicaid participants are connected with a primary care provider who can help them make healthier decisions and get treatment before a condition becomes chronic and more expensive.

Going forward, Medicaid will need to continue the difficult and delicate balance of ensuring that individuals who qualify for Medicaid get access to the services that they need while managing the overall cost of the Medicaid program.

If you have questions about Medicaid, contact DHW at 877-456-1233 or email You can also visit

I hope you have a safe and healthy weekend! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at 

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