On Friday, March 15, United States of Care brought together health care researchers, policy experts and community advocates to discuss Medicaid buy-in. The panel, titled “The Future of Health Care?: Medicaid Buy-In and State Trailblazing in Health Care” was presented in partnership with the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Medicaid buy-in is a flexible, state-based approach that would lower health care costs and increase market competition by allowing people who would not otherwise qualify for Medicaid to “buy in” to Medicaid-like plans. United States of Care has created a library of resources to help policymakers, health care leaders and others interested in this approach understand the aims and design options of a Medicaid buy-in program.
The event kicked off with opening remarks from Andy Slavitt, Board Chair of United States of Care and former Acting Administrator of the Centers for Medicare & Medicaid Services. Slavitt provided an overview of the aims of Medicaid buy-in, highlighting its potential to increase coverage, lower costs, and accomplish those goals in a way that’s sustainable for health care providers and state budgets.
Slavitt then introduced a new video created by United States of Care that breaks down the basics of Medicaid buy-in. The video highlights why states may want to consider this approach to tackle two of our country’s most pressing health care issues – cost and access – by allowing additional people to buy into Medicaid or a similar program.
Moderator Jonathan Cohn, Senior National Correspondent at HuffPost, kicked off the panel discussion. Panelists began by taking a deeper dive into Medicaid buy-in, including major policy considerations and a current lay of the land.
Heather Howard, Lecturer in Public Affairs and Director of State Health and Value Strategies at Princeton University, highlighted key considerations for states interested in Medicaid buy-in, including how this option would work to make health care more affordable. She explained that Medicaid buy-in leverages government purchasing power to create a low-cost insurance option, which can be designed to minimize state risk and maximize the benefit to consumers.
Emma Sandoe, Ph.D. Candidate in Health Policy at Harvard University, noted that Medicaid buy-in is actually not a new idea. “Prior to the ACA, states were creating programs through their Medicaid programs that covered people who weren’t covered by Medicaid. So, the name ‘Medicaid buy-in’ might be new, but the concept of states solving problems that the federal government isn’t solving is as old as the United States,” she said.
John McCarthy, Policy Fellow at United States of Care, drew on his expertise and experience serving as Medicaid Director in Ohio under former Governor John Kasich as well as the District of Columbia, to share his perspective on Medicaid buy-in and policy considerations for states. He also discussed key learnings from New Mexico’s recent efforts to pass Medicaid buy-in legislation. The state recently included funding for additional analysis of Medicaid buy-in in its budget, and the legislature directed the Governor to seek a federal waiver in order to expand access to affordable health care for New Mexicans through a buy-in model.
“One of the issues that has popped up in New Mexico is how to get to a bipartisan agreement. When politics gets in the way, there’s often a reaction to these different proposals, and everyone jumps to their side of the aisle. In New Mexico, they really were trying to figure out how both parties could come together to come up with a design.”
Providing another timely example, Tony Lourey, Commissioner of the Minnesota Department of Human Services, talked about Minnesota’s recent attempts to develop a Medicaid buy-in proposal. Under Governor Tim Walz’s recent ONECare Minnesota plan, people could buy a new state-operated platinum plan on the Marketplace. His plan would also introduce additional gold and silver level plans in areas where the individual market fails to provide options.
“In Minnesota, we decided we wanted to find the places where the market had failed consumers and try to enhance those, and leave a real space for carriers in the individual marketplace. Instead of trying to fix market failures through concessions to carriers, we’re saying that if the marketplace fails in a region, we’re going to fill that void.”
United States of Care is proud to have brought together this group of experts on Medicaid buy-in, so that policymakers and patients alike can better understand the aims and nuances of this approach.
Watch the video to hear full remarks from the panelists.