Idaho Must Use Its Reserve Funds to Protect Medicaid and Rural Health Care

Guest Editorial from Take Back Idaho

Idaho stands at a crossroads. A self-inflicted one. The choice before us is both moral and practical.

As Medicaid faces deep cuts and recipients are pushed closer to crisis, the state continues to sit atop a massive rainy day and reserve fund totaling approximately $1.7 billion. At a time when Idahoans are losing access to care, rural hospitals are teetering on the edge of closure, and entire communities are being hollowed out, the refusal to deploy these funds is indefensible.

Rainy day and reserve funds exist for moments exactly like this. As the old Robin Hood quote reminds us: “Well, it’s raining now.”

The financial argument is straightforward. Idaho’s rainy day fund is currently generating an estimated 7 percent return, equating to roughly $133 million per year. That is public money produced by Idaho taxpayers, sitting largely untouched while essential services are cut.

These funds were not created to gather interest indefinitely. They were designed to stabilize the state during periods of strain. Few situations better meet that definition than a health care system on the brink of collapse.

Hoarding taxpayer money while constantly redefining what constitutes an “emergency” is irresponsible governance. Whistling past the graveyard comes to mind as elected officials sit atop this reserve while their constituents suffer.

No one is advocating for a complete drawdown of the rainy day fund. This is a call for common sense: using a limited, one-time portion of the fund to stop irreparable damage caused by rapid Medicaid cuts that are now being exacerbated by legislative demands.

Medicaid cuts do not occur in a vacuum. They ripple outward, hitting rural hospitals first and hardest. Many of these facilities operate on razor-thin margins and rely heavily on Medicaid reimbursements to keep their doors open. When a rural hospital closes, the damage is immediate and often irreversible. Jobs disappear. Emergency response times increase. Families are forced to travel hours for basic medical care, creating health care deserts.

The cost of preventing these closures now is far lower than the cost of rebuilding health infrastructure later—if rebuilding is even possible.

It is also critical to confront a persistent myth: that Medicaid recipients are largely unemployed or unwilling to work. In reality, a significant majority of Medicaid recipients do work, often full-time, in physically demanding or service-based jobs. The problem is not a lack of effort; it is a lack of access.

Only 41 percent of private companies in Idaho offer health care benefits, leaving hundreds of thousands of workers without employer-sponsored coverage. Many of these jobs provide no dental or vision care, forcing working families to rely on Medicaid for basic health needs. Cutting Medicaid punishes people who are already contributing to the economy while asking nothing more than the ability to see a doctor.

Despite these realities, the Legislature continues to push policies that destabilize local health care while vilifying civil servants as “bureaucrats.” This language is deliberate. It dehumanizes the nurses, administrators, caseworkers, and emergency planners who ensure that Medicaid functions at all.

These are not faceless paper-pushers. They are professionals who keep hospitals open, process claims, and ensure care reaches those who need it. Undermining their work undermines the entire system.

The writing is on the wall. Idaho’s current trajectory increasingly favors austerity for the many and insulation for the few. Party leaders openly signal a vision of Idaho where only the wealthy can afford to live, work, and age with dignity. That vision is incompatible with a healthy, sustainable state.

It is time for serious recalibration. Authorizing the immediate use of rainy day funds to halt Medicaid cuts is not reckless spending. It is responsible governance. It protects rural hospitals, supports working families, and stabilizes communities across the state.

Idaho prides itself on neighborliness and common sense. Those values demand action now.

The rain has already started. The damage is visible. The only remaining question is whether Idaho’s leaders will finally acknowledge the storm—and use the tools already in their hands to protect the people they serve.

Please take a moment to contact your local legislators and ask them to utilize the Budget Stabilization Fund to backfill the cuts already made and to vote against any further cuts to agencies and programs that are already at the end of their tethers.

After all, this is the Idaho way.

About the Author
This article was written by Jennifer Ellis and the Take Back Idaho board of directors.

Sources:
KIVI-TV, “Idaho caregivers fear proposed Medicaid cuts could devastate home-based services; lawmakers say flexibility is limited,” by Sahana Patel, January 2026.

Idaho Capital Sun, “If Idaho cuts Medicaid, ripple effects on the budget are likely; will they drive up costs elsewhere?,” January 26, 2026.