Analysis of legislation introduced in the U.S. Senate that would create a mechanism for states to offer their residents the opportunity to buy a Medicaid-based public insurance option.
What is Medicaid Buy-In?
In August 2017, a new Medicaid buy-in program was proposed for people enrolling in nongroup insurance coverage through the Affordable Care Act (ACA) marketplaces. Given high public support for Medicaid, the intent of the policy is to provide states with an option that, should they take it, would ensure access to affordable marketplace coverage options. In addition, Medicaid buy-in might increase competition in the marketplaces and lead to lower premiums.
Medicaid buy-in could bolster access to affordable care, but challenges exist. The buy-in option would allow eligible residents to use their premium tax credits and reduced cost-sharing requirements would apply as well, to purchase Medicaid-based public insurance plans. However, there would be many differences between a Medicaid buy-in plan and existing Medicaid programs.