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

An Early Look at State Budget Actions in Response to COVID-19 and the Impact on State Health Programs

The COVID-19 pandemic is a public health crisis that has triggered an economic crisis. While the federal government acted to provide financial relief, states have faced significant growth in expenditures in response to the pandemic, as well as simultaneous and severe drops in revenue. This expert perspective provides a snapshot of how states are navigating the known and unknown fiscal challenges of the COVID-19 pandemic, given declining revenues and rising spending demands in the context of balanced budget requirements. The strategies that states employ to address the fiscal fallout of COVID-19, will have significant and long-lasting implications for critical health care and safety net programs.

June 29, 2020

Equitable Recovery Strategies

As state officials shift their focus towards loosening social distancing policies and reopening, they must now grapple with balancing both economic and public health concerns while also considering how reopening policies will impact residents in very different ways, possibly mitigating or exacerbating preexisting disparities. This expert perspective provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their recovery and reopening policies.