Medicaid buy-ins gain traction among states: What you need to know

A number of states are considering expanding access to Medicaid – a federal program that provides health care coverage to low-income families – via a strategy known as a buy-in, Axios reported on Monday.

A Medicaid buy-in refers to a program whereby people who do not qualify for coverage are given the opportunity to retain the program’s services for a fee. The idea is to extend the offer for cheaper coverage to more people, whose incomes and resources exceed the qualification threshold.

States would have to determine which individuals would be eligible for a Medicaid-based public insurance plan, and how much they would have to pay the program. It is considered a toned-down version of “Medicaid-for-all.”

Axios said about 12 states – including Colorado, Connecticut and Oregon – have expressed interest in the strategy, with New Mexico having the most advanced potential proposal so far. States with few insurers on the Affordable Care Act marketplace, high premiums and those who have already expanded Medicaid are likely to consider this option.

In the wake of the midterm elections, 37 states and the District of Columbia had adopted the Medicaid expansion.

Meanwhile, spending on the health care program is among the top drains on state budgets.

A recent report from the National Association of State Budget Officers showed that state spending on Medicaid has accelerated fasted than spending in most other areas – up by 7.3 percent in fiscal 2018 – comprising nearly 30 percent of total spending.

Over the past six years, more than half of growth in state spending is attributable to Medicaid. Growth in spending on the program has averaged 7.6 percent each year since fiscal 2013 – compared to 2.1 percent for the rest of total spending.