H0929 • 2026

HEALTH CARE – Adds to existing law to establish provisions regarding certain out-of-pocket payments for health care services.

Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor: WAYS AND MEANS COMMITTEE
Last action: 2026-04-02
Official status: LAW
Effective date: 2027-01-01

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

HEALTH CARE – Adds to existing law to establish provisions regarding certain out-of-pocket payments for health care services.

What This Bill Does

HEALTH CARE – Adds to existing law to establish provisions regarding certain out-of-pocket payments for health care services.

Limits and Unknowns

This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

2026-04-02 Idaho State Legislature
Reported Signed by Governor on April 2, 2026 Session Law Chapter 275 Effective: 01/01/2027
2026-04-01 Idaho State Legislature
Returned Signed by the President; Ordered Transmitted to Governor
2026-04-01 Idaho State Legislature
Delivered to Governor at 12:50 p.m. on April 1, 2026
2026-03-31 Idaho State Legislature
Returned from Senate Passed; to JRA for Enrolling
2026-03-31 Idaho State Legislature
Reported Enrolled; Signed by Speaker; Transmitted to Senate
2026-03-31 Idaho State Legislature
Received from the House enrolled/signed by Speaker
2026-03-31 Idaho State Legislature
Signed by President; returned to House
2026-03-30 Idaho State Legislature
Read third time in full – PASSED - 29-5-1 AYES – Adams, Anthon, Bernt, Bjerke(Bjerke), Blaylock, Burtenshaw, Carlson, Cook, Den Hartog, Foreman, Grow, Guthrie, Harris, Keyser, Lakey, Lenney, Lent, Okuniewicz, Rabe, Ricks, Ruchti, Semmelroth, Shippy, Taylor, Toews, VanOrden, Ward-Engelking, Wintrow, Woodward NAYS – Hart, Kohl, Nichols, Zito, Zuiderveld Absent and excused – Galloway Floor Sponsor - Cook Title apvd - to House
2026-03-25 Idaho State Legislature
Read second time; filed for Third Reading
2026-03-24 Idaho State Legislature
Reported out of Committee with Do Pass Recommendation; Filed for second reading
2026-03-23 Idaho State Legislature
Received from the House passed; filed for first reading
2026-03-23 Idaho State Legislature
Introduced, read first time; referred to: Commerce & Human Resources
2026-03-20 Idaho State Legislature
Read Third Time in Full – PASSED - 49-21-0 AYES – Beiswenger, Berch, Bingham, Boyle, Bruce, Cannon, Cheatum, Church, Cornilles, Crane(12), Crane(13), Dygert, Egbert, Ehardt, Erickson, Fuhriman, Galaviz, Gannon, Garner, Green, Hall(Stone), Handy, Haws, Healey, Holtzclaw, Manwaring, Mathias, McCann, Mickelsen, Miller, Mitchell, Monks, Nelsen, Palmer, Petzke, Pickett, Pohanka, Raybould, Raymond, Redman, Rubel, Sauter, Shepherd, Shirts, Vander Woude, Veile, Weber, Wheeler, Mr. Speaker NAYS – Alfieri, Barbieri, Burgoyne, Cayler, Ehlers, Furniss, Harris, Hawkins, Hill, Hostetler, Leavitt, Marmon, Mendive, Price, Rasor, Scott, Skaug, Tanner(13), Tanner(14), Thompson, Wisniewski Absent – None Floor Sponsor - Bingham Title apvd - to Senate
2026-03-19 Idaho State Legislature
Read second time; Filed for Third Reading
2026-03-18 Idaho State Legislature
Introduced, read first time, referred to JRA for Printing
2026-03-18 Idaho State Legislature
Reported Printed; Filed for Second Reading

Official Summary Text

HEALTH CARE – Adds to existing law to establish provisions regarding certain out-of-pocket payments for health care services.

Current Bill Text

Read the full stored bill text

LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
HOUSE
OF
REPRESENTATIVES
HOUSE
BILL
NO.
929
BY
WAYS
AND
MEANS
COMMITTEE
AN
ACT
1
RELATING
TO
HEALTH
CARE;
AMENDING
CHAPTER
18,
TITLE
41,
IDAHO
CODE,
BY
THE
2
ADDITION
OF
A
NEW
SECTION
41
-
1854,
IDAHO
CODE,
TO
DEFINE
TERMS,
TO
PRO
-
3
VIDE
FOR
CERTAIN
PROHIBITIONS
AND
DUTIES
OF
HEALTH
CARRIERS
AND
HEALTH
4
CARE
PROVIDERS
WITH
REGARD
TO
CERTAIN
COVERED
PERSONS
WHO
PAY
OUT
OF
5
POCKET
FOR
HEALTH
CARE
SERVICES;
AND
DECLARING
AN
EMERGENCY
AND
PROVID
-
6
ING
AN
EFFECTIVE
DATE.
7
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
8
SECTION
1.
That
Chapter
18,
Title
41,
Idaho
Code,
be,
and
the
same
is
9
hereby
amended
by
the
addition
thereto
of
a
NEW
SECTION
,
to
be
known
and
des
-
10
ignated
as
Section
41
-
1854,
Idaho
Code,
and
to
read
as
follows:
1
1
41
-
1854.
HEALTH
CARE
-
-
CASH
PRICE
FOR
SERVICES.
(1)
As
used
in
this
12
section,
the
terms
"covered
person,"
"health
benefit
plan,"
"health
care
13
provider,"
"health
care
services,"
"health
carrier,"
and
"medically
nec
-
14
essary"
shall
have
the
same
meanings
as
provided
in
section
41
-
5903,
Idaho
15
Code.
16
(2)
A
health
carrier
may
not
prohibit
a
health
care
provider
from
of
-
17
fering
a
covered
person
the
option
of
paying
the
provider's
discounted
cash
18
price
for
health
care
services.
For
the
purposes
of
this
subsection,
"dis
-
19
counted
cash
price"
means
the
charge
that
applies
to
a
covered
person
who
20
pays
cash
for
a
health
care
service.
With
respect
to
a
hospital,
the
dis
-
21
counted
cash
price
shall
have
the
same
meaning
as
provided
in
45
CFR
180.20
if
22
the
hospital
has
a
discounted
cash
price.
It
does
not
mean
the
amount
charged
23
to
individuals
who
are
eligible
for
free
care
or
are
eligible
for
the
amounts
24
charged
pursuant
to
a
hospital's
financial
assistance
policy.
25
(3)
A
covered
person
may
choose
to
pay
out
of
pocket
for
a
health
care
26
service
from
a
health
care
provider.
27
(4)
If
a
covered
person
obtains
a
medically
necessary
health
care
ser
-
28
vice
covered
by
such
person's
health
benefit
plan
and
negotiates
for
a
price
29
lower
than
the
allowed
amount
established
by
the
benefit
plan,
as
provided
30
to
the
covered
person
upon
request,
and
the
covered
person
pays
out
of
pocket
31
for
the
health
care
service,
the
amount
of
the
out
-
of
-
pocket
cost
shall
be
32
counted
toward
the
covered
person's
out
-
of
-
pocket
deductible
and
annual
33
maximum
out
-
of
-
pocket
expense
if
the
requirements
of
this
section
are
met.
34
(5)
A
health
carrier
that
receives
the
documentation
described
in
35
subsection
(6)
of
this
section
shall
count
the
full
amount
that
the
cov
-
36
ered
person
paid
out
of
pocket
toward
the
deductible
and
annual
maximum
37
out
-
of
-
pocket
expense
if:
38
(a)
The
health
care
service
is
covered
under
the
health
benefit
plan
of
39
the
covered
person;
and
40

2
(b)
The
covered
person
negotiated
for
a
lower
cost
for
the
health
care
1
service
than
the
allowed
amount
established
by
the
covered
person's
2
health
benefit
plan
for
that
covered
health
care
service.
3
(6)
A
covered
person
shall
electronically
send
documentation
to
the
4
health
carrier
that
provides
the
following
information:
5
(a)
The
health
care
services
the
covered
person
or
patient
received
and
6
the
name
of
the
health
care
provider
and
contact
information;
7
(b)
The
final
bill
or
statement
for
the
health
care
services;
and
8
(c)
The
negotiated
cost
of
the
health
care
service
that
the
covered
per
-
9
son
received
and
documentation
that:
10
(i)
The
covered
person
paid
out
of
pocket
for
the
health
care
ser
-
1
1
vices
received;
and
12
(ii)
The
health
care
provider
is
not
making
a
claim
against
the
13
health
carrier
for
payment
of
the
health
care
service
provided
to
14
the
covered
person
or
patient.
15
(7)
The
health
care
provider
shall
accept
the
discounted
cash
payment
16
from
the
covered
person
as
payment
in
full
and
shall
not
bill
the
covered
per
-
17
son
or
the
health
carrier
for
any
balance
between
the
amount
collected
from
18
the
covered
person
and
the
billed
charge
for
the
service
by
the
provider.
19
(8)
The
amount
of
the
out
-
of
-
pocket
cost
shall
be
attributed
to
the
20
in
-
network
deductible
and
annual
maximum
out
-
of
-
pocket
expense
if
the
21
provider
was
an
in
-
network
provider
and
to
the
out
-
of
-
network
deductible
and
22
annual
maximum
out
-
of
-
pocket
expense
if
the
provider
was
an
out
-
of
-
network
23
provider.
24
(9)
The
amount
counted
toward
an
applicable
out
-
of
-
pocket
deductible
25
and
annual
maximum
out
-
of
-
pocket
expense
shall
not
exceed
the
total
amount
26
that
the
covered
person
is
required
to
pay
out
of
pocket
during
a
contractu
-
27
ally
agreed
on
period
of
time
for
health
care
services
that
are
included
un
-
28
der
the
health
benefit
plan
of
the
covered
person
and
shall
not
carry
over
29
once
a
new
contract
or
agreement
period
for
the
plan
begins.
30
(10)
The
provisions
of
subsections
(4)
through
(9)
of
this
section
shall
31
not
apply
to:
32
(a)
A
plan
that
provides
coverage:
33
(i)
Only
for
a
specified
disease
or
diseases;
34
(ii)
Only
for
accidental
death
or
dismemberment;
35
(iii)
Only
for
dental
or
vision
care;
36
(iv)
Under
an
individual
limited
benefit
policy;
37
(v)
For
a
hospital
confinement
indemnity
policy;
38
(vi)
For
disability
income
insurance
or
a
combination
of
acci
-
39
dent
-
only
and
disability
income
insurance;
or
40
(vii)
As
a
supplement
to
liability
insurance;
41
(b)
Any
programs
administered
by
the
Idaho
department
of
health
and
42
welfare
through
the
state
medicaid
program
under
title
XIX
of
the
fed
-
43
eral
social
security
act,
as
amended;
44
(c)
A
medicare
supplemental
policy
as
defined
by
section
1882(g)(1)
of
45
the
social
security
act;
46
(d)
Worker's
compensation
insurance
coverage;
47
(e)
Medical
payment
insurance
issued
as
part
of
a
motor
vehicle
insur
-
48
ance
policy;
49

3
(f)
A
long
-
term
care
policy,
including
a
nursing
home
fixed
indemnity
1
policy,
unless
a
determination
is
made
that
the
policy
provides
bene
-
2
fit
coverage
so
comprehensive
that
the
policy
meets
the
definition
of
a
3
health
benefit
plan;
or
4
(g)
Short
-
term
health
insurance
issued
on
a
nonrenewable
basis
with
a
5
duration
of
six
(6)
months
or
less.
6
(11)
Nothing
in
this
section
shall
be
construed
to
waive
or
override
7
prior
authorization,
medical
necessity,
or
utilization
management
require
-
8
ments
under
the
health
benefit
plan.
9
SECTION
2.
An
emergency
existing
therefor,
which
emergency
is
hereby
10
declared
to
exist,
this
act
shall
be
in
full
force
and
effect
on
and
after
1
1
January
1,
2027.
12