Why Medicaid Buy-in?

With the Federal government in gridlock, states are taking the lead in finding innovative approaches and new coverage options to make health insurance more affordable and accessible.

Health care continues to cost Americans too much, and with a divided federal government, meaningful federal action to expand coverage or improve affordability is highly unlikely for the next two years. In the near-term, states will be the testing grounds for developing new ways to expand insurance coverage.

States control a broad portion of the health care marketplace, including running Medicaid, the program that provides health coverage to 1 in 5 Americans. States can use their experiences and existing infrastructure to add another, more affordable choice to the market. Medicaid buy-in is not a one size fits all policy; instead, states can use this idea to design an approach that will best address their state’s unique needs.

With states taking varying approaches to this new policy idea-- and lots of common questions about what Medicaid buy-in actually is-- this site aims to bring together the latest state by state progress on Medicaid buy-in 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


Following a detailed study of policy options, the New Mexico state legislature is considering legislation to create a Medicaid buy-in. Momentum for Medicaid buy-in has been building, with at least 8 municipal governments representing more than 60% of the population endorsing Medicaid buy-in. Most recently, the legislation received a hearing in the Senate Public Affairs Committee.

SB 405 passed through the Senate Public Affairs committee on February 14, on a 4-3 vote and is headed to the Senate Finance committee. HB 416 passed out of the Health and Human Services Committee on February 15 on a 5-0 vote and is headed to the House Appropriations and Finance Committee.

United States of Care partnered with Health Action New Mexico in 2018 to launch US of Care New Mexico, which is supporting the New Mexico Together for Health Care coalition in their work to design and enact a Medicaid buy-in plan for the state.

Public Opinion