Why Medicaid Buy-in?

Healthcare continues to cost Americans too much, and with no consensus on the horizon in Washington, meaningful action to address coverage and affordability is less likely at the federal level. States continue to  be the testing grounds for developing new ways to expand insurance coverage.

States have control over a broad portion of the health care marketplace, including Medicaid, a program that provides health insurance coverage to 1 in 5 Americans. States can leverage their experience administering Medicaid, along with already existing infrastructure, to add another, more affordable insurance option to the market. This type of plan, known as a Medicaid buy-in, is not a one-size-fits-all policy—instead, state leaders can modify this idea to design an approach that will best meet their unique needs. States have also adapted this concept to create other buy-in options that do not rely on Medicaid’s infrastructure  but still aim to provide more affordable options to individuals and families by leveraging other state-run programs.

Given that states are taking diverse approaches to this new policy idea— and caregivers, patients, and other stakeholders share  common questions about what a buy-in plan might look like in their state— this site aims to bring together the latest state-by-state progress on Medicaid buy-in and other buy-in options, along with additional resources and background information.

2018-2019 Medicaid Buy-in Activity


If you are aware of Medicaid buy-in state activity that is not mentioned here, let us know by contacting us.

State Spotlight


The legislature voted to appropriate funds (through SB 536 and HB 548) to the Human Services Department to study and begin “administrative development” of a Medicaid Buy-in plan, including pursuing federal funding through a 1332 waiver. This study builds on the initial study done in early 2019 showing the merits of different Medicaid buy-in options for the state.