Idaho is the 11th largest state in the United States, spanning more than 82,600 square miles. Nearly 88% of that land lies in rural counties, home to over a quarter of Idaho’s population. According to the U.S. Census, more than one in five residents in rural counties such as Adams, Custer, and Lemhi are age 65 or older. Many are ranchers, farmers, and landowners, critical individuals essential to Idaho’s agricultural economy.

Yet, Idaho’s healthcare workforce is failing to keep pace. While the national population grew by 1%, Idaho’s population increased by 8.2% between 2023 and 2024, an increase of more than 150,000 people. Despite the growth, Idaho ranks 50th in the nation for primary care physicians. Even adding 1,400 doctors overnight would only bring the state up to the national average.

The question is not whether Idaho needs more physicians; it does. But how to address the shortage responsibly, maximizing every taxpayer dollar while building a sustainable workforce?

Unlike most states, Idaho does not have an in-state public medical school. Instead, Idaho invests in established regional partnerships, most notably the WWAMI program through the University of Washington and a program with the University of Utah.

In 2025, Idaho spent $10.6 million supporting Idaho medical students through these programs. The results matter: 72% of Idaho students trained through WWAMI return to practice in the state. These physicians are trained in rural and community hospitals, exactly where Idaho’s need is greatest.

Some have proposed reduced participation in WWAMI or expanding new medical seats outside existing programs. While well-intentioned, these proposals carry serious fiscal risk. Cutting WWAMI could undermine decades of taxpayer investment and the pipeline of Idaho-trained physicians. Meanwhile, adding a small number of new seats without the clinical networks, faculty, and mentorship systems already in place may do little to solve the shortage.

The legislature’s passage of House Bill 368 in 2025, creating a working group to explore a state-supported medical school, reflects growing concern. Building a new public medical school is neither quick nor inexpensive. Estimates suggest at least $250 million in upfront costs, plus $20-50 million annually in operating expenses before a single doctor even enters the workforce. This is a high-cost gamble with delayed returns.

Healthcare is not just a public health issue but an economic infrastructure issue. Rural communities without physicians struggle to retain businesses and attract workers. Delayed care increases emergency room use and drives up long-term costs borne by taxpayers, employers, and families alike.

Idaho should maintain and strengthen WWAMI while expanding incentive-based policies that encourage physicians to train, practice, and stay in the state. Loan forgiveness, salary supplements, and compensation for physicians who mentor medical students have proven effective in other states. These tools leverage existing systems, deliver faster results, and avoid the risk of building expensive institutions from scratch.

The evidence is clear. WWAMI returns nearly three-quarters of Idaho-trained physicians to in- state-practice. Demand far exceeds supply with more than 160 applicants competing for just 40 seats each year. Expanding a proven program rather than abandoning it offers the best return on investment

Idaho’s physician shortage is urgent but solvable. By choosing fiscally responsible solutions that build on what already works, Idaho can ensure rural communities receive care, strengthen the economy, and honor its responsibility to taxpayers. Maintaining WWAMI and pairing it with targeted incentives is the most optimal way to secure a strong, sustainable medical workforce for Idaho.