The Landscape of Federal and State Healthcare Buy-In Models

Prepared with the support of Arnold Ventures

Across the country, policymakers, healthcare stakeholders and consumer advocates are motivated to expand affordable coverage, with the overarching goals of lowering the uninsured rate, addressing affordability and access-to-care issues (such as high premiums, deductibles and cost-sharing), and reducing the cost of healthcare borne by individuals and state and federal governments. Bolstered by the popularity of public health insurance programs and public interest in increasing insurance market stability, policymakers and stakeholders are turning their attention to government-sponsored “buy-in” programs or “public options.”

Buy-in programs (which can include public options) involve the federal or state government offering consumers a new, more affordable healthcare coverage option by leveraging, in some way, the administrative savings and bargaining power of public programs, such as Medicare or Medicaid.

In a new paper funded by Arnold Ventures, Manatt Health provides an overview and discussion of several types of buy-in programs being considered at the national and state levels—federally sponsored buy-in models that leverage Medicare, and state-sponsored buy-in models that leverage Medicaid or the Basic Health Program, a state option made available under the Affordable Care Act.

Choosing the appropriate model will depend, in large part, on the problems policymakers are hoping to resolve. In exploring the myriad design options and impacts of various buy-in models, this paper presents both the merits and limitations of federally sponsored and state-sponsored buy-in programs and provides an overview of key considerations for policymakers and stakeholders as they consider buy-in as a tool for ongoing health reform.

Click here to read the full paper.

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