Idaho’s decision in late 2025 to cut Medicaid‑funded assertive community treatment (ACT) sparked a wave of preventable deaths among people with severe mental illness. The program, which paid multidisciplinary teams to make home visits and administer long‑acting antipsychotics in early 2025, served 226 patients statewide. Within weeks, four individuals—including 45‑year‑old Lorenzo Pahvitse‑Rodriguez of the Shoshone‑Bannock Tribes—were found dead after refusing care.

Families say the missing nurse visits likely would have caught infections that turned lethal. In Nampa, 49‑year‑old Carl Adair died of pneumonia and sepsis; in Arco, a 36‑year‑old was discovered in a closet; and a Boise man in his 40s ignored medication for a chronic condition. The string of deaths prompted Republican lawmakers, including Sheriff Sam Hulse, to reverse the cuts and restore ACT funding.

Idaho faces a fiscal squeeze after $1.3 billion in annual income‑tax reductions and a constitutional ban on deficits. Governor Brad Little’s 3 percent agency‑wide cut order forced Medicaid contractor Magellan to eliminate ACT, betting that jail and emergency room costs would be lower. The sudden mortality spike proved the gamble wrong, forcing the state to reinvest in the program.