BOISE, Idaho (AP) — The House approved federally-required changes to the state's Medicaid program after a prolonged debate that could be a precursor to upcoming rancor over whether Idaho should adopt a state-based insurance exchange. Tuesday's 48-21 vote allows Idaho to spend $7.2 million in mostly-federal money on its Medicaid readiness project, to implement changes required under President Obama's 2010 health insurance overhaul.

The measure now heads to the Senate. Anytime anything related to "Obamacare" is up for a vote in Idaho, foes of the plan are ready for a fight. Republican Rep. Pete Nielsen of Mountain Home urged opposition, calling this one of those times when Idaho needed to start acting like a sovereign state. Supporters, however, pointed out Idaho risked losing millions in Medicaid funding if it didn't agree to the changes.