In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
Medicaid Buy-in: State Options and Design Considerations
In recent months, several proposals have been introduced at both the federal and state levels that would permit people above Medicaid eligibility levels to “buy in” to Medicaid or would leverage the Medicaid program to strengthen coverage across the individual market and Medicaid. In this webinar, the Robert Wood Johnson Foundation’s State Health and Value Strategies (SHVS) program, together with technical assistance experts from Manatt Health, examined 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 also reviewed Section 1332 waiver authority and related deficit neutrality and pass-through funding implications that states will want to consider as they craft their buy-in proposals. We also highlighted states’ current efforts to develop buy-in initiatives.