An Idaho attorney general's advisory opinion on HB 117, the health care nullification law, says the bill could have an unforeseen impact: Opting Idaho out of receiving its entire portion of federal Medicaid matching funds. Examining "its effect on existing and future Idaho participation in the Medicaid program," the opinion says, "As a purely voluntary program, Idaho's refusal to comply with the expanded provisions within the PPACA (the Patient Protection and Affordable Care Act) could potentially result in Idaho exiting the program and losing the existent federal matching funds. This could create a situation where individuals presently covered would no longer be covered, yet still require medical treatment, which likely would be required to be provided for and paid for through some non-federal means."

"This situation, in turn, could create an intense burden on the State's budget," the opinion states. "In sum, the Legislature may wish to consider whether its adoption of RS 20315 (now HB 117) has the practical and legal effect of opting Idaho out of Medicaid and its attendant federal funding." You can read the full opinion here.