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State Medicaid Buy-Ins: Key Questions to Consider

Lawmakers across the country are considering Medicaid buy-in programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. Medicaid buy-in models are chief among the emerging state-based solutions. So far in the 2019 legislative session, more than 10 states have introduced legislation to study or implement a buy-in.

This brief dives deep into the key questions that states pursuing Medicaid buy-in or public option models will want to consider as they seek to design and implement their proposals. The companion State Health Policy Highlight, State Considerations for Medicaid Buy-In Proposals,  provides a checklist summarizing key questions and themes laid out in greater detail in the underlying brief.



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