In this report, SHARE grantee Genevieve Kenney and co-author Jennifer Pelletier detail policy changes in Idaho's Medicaid program that were implemented under authority granted by the Deficit Reduction Act of 2005 (DRA).  This authority allowed the state greater flexibility in benefit design, cost-sharing, care coordination, health promotion, and chronic disease management.  The authors evaluate the impacts of Idaho's Medicaid policy changes, along with the political, regulatory, and institutional environment that influenced these impacts.