Issue Briefs | May 14, 2018

Medicaid Buy-In: State Options, Design Considerations and Section 1332 Waiver Implications

Patricia Boozang, Chiquita Brooks-LaSure and Ashley Traube, Manatt Health

States continue to identify and pursue strategies to further reduce the number of uninsured, to make coverage more affordable for consumers and to improve access to care. 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. This issue brief presents two possible models for a Medicaid buy-in program for states, and details the design considerations and authorities needed to implement each model.

The State Health Policy Highlight, Medicaid Buy-In: What Is It? And How Can It Be Useful to States? provides an overview of the concept of Medicaid buy-in and outlines the issues states can solve for by implementing a Medicaid buy-in program.

State Health and Value Strategies hosted a companion webinar, Medicaid Buy-in: State Options and Design Considerations based on the issue brief that provided an overview on Medicaid buy-in and explored the two models profiled in the issue brief.


Expert Perspectives

November 17, 2022

Communicating the PHE Unwinding: How States Are Conducting Outreach and Planning

At the end of the federal public health emergency, states will need to redetermine eligibility for nearly all Medicaid enrollees in the largest healthcare event since the Affordable Care Act. In order to avoid potential coverage losses, states will need to communicate with enrollees and other stakeholders about the actions they need to take to keep individuals enrolled in Medicaid or transition to another form of health coverage. One way that states are promoting transparency in their communications and planning efforts is through the public release of their unwinding operational plans. This expert perspective highlights several states that have made their unwinding operational plans publicly available as well as examples of states’ ongoing communication efforts, including outreach campaigns to Medicaid enrollees, strategies for collaborating with stakeholders, and collaborative initiatives within Marketplace states. This expert perspective has been updated as of November 17, 2022 to reflect recently released state unwinding operational plans.