Last week, Emma Sandoe and I wrote in the Health Affairs blog an outline on how to think about evaluating Medicaid buy-in proposals. We thought that as the primary season is opening up and the chaos in the individual market, that more states will start thinking about Medicaid buy-in options for the individual market. From here, the most critical thing in evaluating a Medicaid buy-in proposal is identifying what the sponsors are seeking to achieve with such a proposal. We think there are several goals that could be achieved via a Medicaid buy-in. Some of these goals may be in opposition to each other.
- Increase the value and breadth of coverage in the Individual Market
- Offer more options to people living in low competition regions
- Stabilize and improve the viability of the individual market by eating some strategic risk
- Lower premiums for individuals in the individual market
- Increase consumer protections in the individual market
- Leverage the current combined Medicaid and individual market power to push system delivery reforms.
The key challenge to evaluate any buy-in proposal is figuring out what it is trying to do. Once that is identified, the evaluation is fairly straightforward but if you are an advocate, please press your representatives to clearly articulate the problem that they are trying to solve with this policy. That is just good advice in general.