State Efforts to Develop Medicaid Buy-In Programs

Heather Howard

In the absence of federal legislation to stabilize the individual market, states are examining strategies to strengthen their marketplaces and maintain coverage gains.  In recent months, states have increasingly introduced proposals for individuals above Medicaid eligibility levels to “buy-in” to Medicaid or leverage the Medicaid program to strengthen coverage across the individual market and Medicaid. These Medicaid buy-in programs offer states an opportunity to make coverage more affordable and accessible in their state.

We have mapped out current state activity and included links to relevant legislation. You’ll see that several states are actively pursuing the development of a program while a few are establishing task forces or study groups to understand the impacts of such a program on health care access and cost in their state.

In addition to the map, State Health and Value Strategies has published an issue brief, authored by Manatt Health, highlighting state options, design considerations, and section 1332 waiver implications for states considering Medicaid buy-in programs.

On Tuesday, May 15, State Heath and Value Strategies, with technical experts from Manatt Health, will host a webinar based on the issue brief and highlight the central considerations that a state must take into account when developing a Medicaid buy-in proposal; the primary models for state-administered Medicaid buy-in proposals; and the administrative considerations and authorities needed for each model. The webinar will also highlight current state models to develop buy-in proposals.