Could Medicaid Buy-In Push Aside Medicare for All?

Officials in ten states are giving consideration, in one form or another, to permitting uninsured low-income residents to buy into their Medicaid programs.

So while Washington considers the possibility of Medicare for all, the ten states – Nevada, New Mexico, California, Delaware, Oregon, Washington, Connecticut, Illinois, Minnesota, and Wisconsin – are tackling the many issues they must address if they intend to pursue such a ground-breaking option.  Among them:

  • Who would be eligible to participate?
  • What benefits would be offered?
  • Would health plans be available on Affordable Care Act health exchanges, and if so, would ACA subsidies be available to potential purchasers?
  • How would cost-sharing, such as premiums, co-pays, and deductibles, be addressed?
  • In the absence of federal matching funds, how would the states pay for their share of Medicaid benefits purchased by those not eligible for Medicaid?
  • Would such as effort be approved by the federal government?

To the extent that Medicaid buy-in would turn uninsured patients into insured patients, Medicaid buy-in would be beneficial for private safety-net hospitals.

Learn more about what the states are considering and the potential obstacles they face in the Stateline article “Medicaid ‘Buy-In’ Could Be a New Health Care Option for the Uninsured.”


New Report Looks at Medicaid Buy-In

While there has been a great deal of public discussion of late about “Medicare for all,” less attention has been paid to the concept of permitting people to buy into their state’s Medicaid program.

Now, the Rockefeller Institute of Government has published a new report that presents the different approaches to the concept of Medicaid buy-in.

It also seeks to address six major questions of potential Medicaid buy-in efforts:

  • How large is the intended population of new enrollees?
  • What kind of coverage would be offered?
  • How would enrollment be financed?
  • How would rates be set?
  • Would the program use standard Medicaid rate and would there be enough participating providers to meet enrollee demand?
  • How would such a program fit into individual states’ regulatory structure?

Medicaid buy-in would be of great interest to private safety-net hospitals because they serve communities in which many residents remain uninsured.

Learn more about how the concept of Medicaid buy-in and how it might work by reading the Rockefeller Institute of Government report “Medicaid Buy-In: Questions of Design and Purpose,” which can be found here.