Though murmurs of “Medicare for all” can be heard frequently in Washington these days, enrolling all U.S. citizens in a single-payer plan doesn’t look likely anytime soon. Some states have begun searching for ways to provide affordable healthcare coverage to more of their populace while balancing the logistics of comprehensive coverage.
The Medicaid Buy-In Option
Currently available in a few states under specific circumstances, a Medicaid buy-in allows people to pay a premium to participate in the federal-state healthcare program that was designed for the poor. Advocates for expanded Medicaid buy-ins argue the policies could be an option for those who have difficulty affording plans offered through a healthcare exchange. They also suggest the competition created might lower prices for everyone.
Allison O’Toole, senior director of state affairs for United States of Care, said, “We think 2019 is going to be the year of Medicaid buy-in.” United States of Care advocates affordable healthcare for all and believes that states, not the federal government, should be the ones to offer solutions to the healthcare crisis. Voters seem to agree with a Medicaid buy-in approach. A recent survey showed 78 percent of registered voters across the U.S. support the idea of Medicaid buy-ins.
Compromise Could be the Key
While a Medicaid buy-in seems to be enjoying widespread support, it has its detractors. Many healthcare providers, including hospitals, are opposed to the idea based on Medicaid’s lower reimbursement rates when compared to commercial reimbursements. Hospitals are worried they will lose money if patients choose buying into Medicaid over traditional commercial options.
Some state lawmakers share these concerns. Minnesota Senate Majority Leader Paul Gazelka, a Republican, said a buy-in is not “a viable option” in his state. He’s concerned that providers will go out of business because they won’t receive fair payment due to low reimbursement rates. He points out that advocates haven’t disclosed how they would raise the money to support such a plan.
In the current political climate, it’s difficult for any new idea to gain traction across party lines. This one is no different, and some advocates of Medicaid buy-in plans acknowledge that reimbursement rates may need to be increased by the states. It may be the only way to get enough providers to participate and make these plans a viable option for those needing affordable healthcare coverage.
With the federal government at a standstill, there are nearly 20 states considering Medicaid buy-in options and at least six with proposals on the table.