Medicaid ‘Buy-In’ Could Be a New Health Care Option for the Uninsured

Even as calls for “Medicare for All” grow louder among Democrats in Washington, D.C., at least 10 states are exploring whether to allow residents to pay premiums to “buy in” to Medicaid, the federal-state health care program for the poor. Currently, Medicaid recipients pay for their coverage in only a handful of states, and the buy-in plans that states are considering might not offer the full range of benefits available to traditional beneficiaries. But advocates say the policies might be an appealing option for people hard-pressed to pay for plans on the health care exchanges, and spur competition that could lower prices for everybody.The concept of enrolling all Americans in Medicare, the federal health insurance program for the elderly, is probably a nonstarter in politically polarized Washington — at least for now. So, states have started looking at other ways to provide health care to more people at more affordable prices.Nevada’s legislature passed a Medicaid buy-in program in 2017, only to have its then-Republican governor, Brian Sandoval, veto it, saying the state needed more time to study the plan. Legislative supporters say they are planning to file a new bill shortly and are optimistic about passage. The state now has a Democratic governor. Studies of a buy-in option also are ongoing in California, Delaware, New Mexico, Oregon and Washington. And newly elected governors in Connecticut, Illinois, Minnesota and Wisconsin have pledged support for Medicaid buy-in.