Idaho bill to ensure health care providers are hired and trained for merit, not DEI

By HPN Staff

The Idaho House of Representatives is considering a bill that would base employment and contract decisions tied to Medicaid providers on merit rather than “diversity, equity and inclusion” (DEI) criteria.

The Merit-Based Health Care Act, which would ensure health care providers receiving Medicaid funds make employment and contract decisions based on merit, professional qualifications and clinical competency rather than ideological considerations or discrimination.

Currently before the House Business Committee, the bill prohibits discrimination in hiring, promotion, compensation, discipline, termination, training or other employee-employer contractual agreements. The legislation authorizes the state’s Attorney General to investigate violations and seek civil penalties and empowers the Idaho Department of Health and Welfare to investigate network-wide compliance for Medicaid managed care contractors. All Medicaid provider agreements would need to comply with the bill.  

“A merit-based health care system strengthens trusts, improves outcomes and ensures that resources are directed towards excellency and efficiency,” said the legislation’s sponsor Rep. Clint Hostetler. 

Why it matters

Merit-Based Health Care Act targets DEI practices at health institutions that receive Medicaid funds. The federal Medicaid program is funded by federal and state taxpayer dollars. Specifically, it would: 

• Ban discrimination in hiring and contractual agreements by granting preference or disadvantage based on race, sex, sexual orientation, gender identity or national origin, except as expressly required by federal law; 
• Ban policies and practices that stereotype, scapegoat, favor or disfavor individuals based on race or sex or disparage characteristics like character, hard work and meritocracy as inherently racist or sexist; 
• Ban “race-based” or “sex-based” preferences; targets, benchmarks, quotas or equity goals;
• Ban training that emphasizes mandatory bias, implicit bias or systemic bias; 
• Ban required diversity statements or pledges; 
• Ban practices that assign responsibility, disadvantage or professional outcomes based on protected characteristics rather than individual merit or performance;
• And, ban the promotion of DEI in public communications. 

Two House representatives, Megan Egbert and Lori McCann, conveyed concern about what could happen to Medicaid providers that already have contracts with the state should the bill pass. 

The bigger picture

Authorized in 1965, the $919 billion Medicaid program (2024 figures), provides health insurance for individuals with limited income. Although funded and managed primarily by each state, the federal government also provides funding and regulations. Idaho and other states with lower per capita incomes have a higher percentage of federal funding. 

Although the Trump Administration has taken steps to eliminate DEI offices, positions, plans, contracts and commissions, state actions have varied. 

This would be the first bill to target DEI discrimination in taxpayer-funded health institutions. Last year, Idaho Governor Brad Little signed Senate Bill 1198, prohibiting DEI offices, DEI hiring and admission practices and DEI training at public colleges and universities.